ETHOS

I have chest pain that started 10 minutes ago and my family has a history of heart disease.

Patient

Hi, I'm experiencing some discomfort and I'm not quite sure what to do. Could you please help me?

Triage Assistant

Where does it hurt?

Patient

It's actually in my chest.

Triage Assistant

Does the pain go anywhere else, like your neck, jaw, arms, or back?

Patient

It's mainly in my chest, but I think I might feel a bit of discomfort radiating to my left arm.

Triage Assistant

When did the chest pain begin?

Patient

It started about 10 minutes ago.

Triage Assistant

Is the pain constant since it started, or does it come and go? Does it get worse with exertion?

Patient

It's been fairly constant since it started and doesn't really change with exertion.

Triage Assistant

How long does each episode of pain last? For example, does it last seconds, minutes, or hours?

Patient

This particular episode has been continuous for the last 10 minutes without any breaks.

Triage Assistant

How bad is the pain on a scale of 1 to 10, where 1 is mild and doesn't interfere with normal activities, 4-7 is moderate and interferes with normal activities or awakens you from sleep, and 8-10 is severe, excruciating pain that makes you unable to do any normal activities?

Patient

I'd say it's around a 6 or 7. It’s definitely making it difficult for me to focus on anything else.

Triage Assistant

Do you have any history of heart problems or risk factors for heart disease? For example, angina, a prior heart attack, diabetes, high blood pressure, high cholesterol, smoking, or a strong family history of heart disease?

Patient

Yes, my family has a history of heart disease.

Triage Assistant

You need to call 911 right now. This could potentially be a heart attack, and you should get immediate medical attention. If there's no allergy to aspirin, you may chew an aspirin (160 to 325 mg) while waiting for the paramedics to arrive. Thank you for calling, goodbye.

Dispositions

  • Call EMS 911 Now

  • See More Appropriate Protocol

  • Go to ED Now

  • Go to ED/UCC Now (or to Office With PCP Approval)

  • Callback by PCP Within 1 Hour

  • See in Office Today

  • Home Care

  • Triage result was accurate.

  • First aid advice was given.

  • Some assessment questions asked.