Angina in Emergency Room – FTCC Multidisciplinary Simulation Clinical
06
October

By Adem Lewis / in , , , , , , , , , , , , /


He started having some chest pain. He does have some significant cardiac history. They already have him on some oxygen. We’ve got a baseline in the vital signs. We’ve established an IV, 18 gauge, right AC. He was still having some substernal chest pain at a rate of about 7. So, we gave him nitroglycerin times two. 0.4 miligrams His blood pressure held fine during that. Alright, Mr. Smith they’re going to take good care of you. (Patient) Thank you so much. (Doctor walking) You’re welcome. (LPN middle) Hi! I’m Jessie. I’m gonna be the one LPN’s that’s working with you today. (LPN left) And I’m Kassie. I’m another LPN that will be working with you. (RN right) And I’m Janel. I’m an RN. I’m going to be helping out with your care today as well. (Patient) Hi everybody. (LPN) How are you feeling? (Patient) Oh, my chest is just hurting really bad. (LPN) What would you level your pain at between 1 and 10? (Patient) I’d say about… about a seven. (LPN) Is it radiating? Is it going anywhere else? (Patient) Yeah. It goes into my… my left arm. (LPN right) Into your left arm? (LPN left) Four liters of oxygen are on. (LPN right) I’m going to get your Pulse Ox on okay? (Patient) Pulse Ox? What’s that? (LPN right) It’s just going to tell how you’re breathing. I’m just going to place it right here on your finger. (LPN left) I’m going to hook you up to a Five Lead. (RN left) Mr. Smith, we understand that you’re allergic to penicillin. Is there anything else you’re allergic to? (Patient) That’s all. Janel, am I going to die? (RN left) No. We’re taking good care of you. We got some oxygen that’s going to help your breathing. and we’re also going to get some medication to help you with your pain. I’m going to go ahead and get the nitro for him. (LPN right) Okay. I’m going to take his blood pressure really quick. Mr. Smith, I’m just going to take your blood pressure. (Patient) Thank you guys for taking good care of me. (LPN right) Oh, You’re welcome. (RN left) Kassie, do you want to go ahead and give him some nitro? (LPN left) Yeah. (Off Camera) Make sure his blood pressure’s okay. (LPN left) Mr. Smith, could you state your name one more time and your date of birth? (Patient) Frank Smith. 4/19/1950. (LPN left) Okay. Do you have any allergies? (Patient) I’m allergic to penicillin. (LPN left) Penicillin. Do you take any ED medications? (Patient) ED medicines? What do you mean? (LPN left) For Erectile Dysfunction. (Patient) For my Erectile Dysfunction? (LPN left) For Erectile Dysfunction. (Patient) Oh, no Ma’am I don’t. (LPN left) Okay. I’m going to have you put this under your tongue. And just hold it there (Patient) What is this supposed to do? (LPN left) Well it’s going to vasodilate your coronary arteries and help take away some of that pain. (Patient) Oh thank god. (RN left) Jessica, how is his blood pressure? (LPN right) It was good. It’s 128 over 82. (RN left) 128 over 82. Okay. (RN left) I’m going to go ahead and get some morphine for our chest pain protocol to see if it will help with his pain. (LPN right) Did the nitro help any? (Patient) It did. Well you know I’m about a 5 out of 10 now. (LPN right) Okay. Well, Janel’s going to go get you some morphine to help out with that. (LPN left) I’m going to call RT and get a 12 lead in here. (RT left) Patient’s name? (LPN right) Frank Smith. (RT left) Mr. Smith, how are you doing? My name is Brian. I’m from Respiratory Therapy. (Patient) Wow. Hi, Brian! (RT left) I’ve come to give you an EKG today. How are you feeling? (Patient) Well you know I was having bad chest pain but I’m starting to feel a little bit better. (RT left) Okay. What were you doing? (Patient) I was just getting my teeth cleaned and now I’m here. (RN left) Okay, Mr. Smith, while Brian’s hooking you up I’m going to go ahead and give you your morphine. How is your pain level right now? (Patient) Well, It’s about a 4 out of 10 now. (RN left) Okay. And his blood pressure is? (LPN right) Blood pressure is 128 over 82. Are you taking any other medications, Mr. Smith? (Patient) Yeah. I’m on a medicine for my cholesterol. It starts with a z. But you can look that up on the computer. A low presser and something for my diabetes. (RT left) What I’m going to do is put some stickers on your chest and we’re going to hook these leads to it and it’s basically going to give us a little picture of what going on with your heart okay? (Patient) Okay. It doesn’t hurt at all? (RT left) No. It’s not going to hurt you one bit. (RN left) Okay, Mr. Smith, I just gave you 4 milligrams of morphine and we’re going to see how that makes you feel okay? (Patient) Oh, that morphine is making me feel really good. (RT left) You have a history of smoking? (Patient) Yeah. I smoked about twenty years ago. (RT left) Yeah? (Patient) But my doctor told me I needed to stop. (RT left) Are you still smoking? (Patient) No. I stopped. (RT left) Okay. (RT left) Okay, Mr. Smith, I need you to hold really still for me okay? (Patient) Okay (RT left) Okay. All done. (Patient) Thank you so much. (RN left) Mr. Smith, How are you doing? (Patient) I’m doing really good. (RN left) How’s your pain level now? (Patient) Oh, wow! I can’t even tell you I have pain right now. (RN right) That’s good! We’ll go ahead and let the doctor know how you’re doing and he’ll be in here in just a few minutes okay? (Patient) Okay. Thank you very much.


10 thoughts on “Angina in Emergency Room – FTCC Multidisciplinary Simulation Clinical

  1. When this was posted Frank Smith was roughly 61 years old and had quit smoking 20 years ago at age 41. This is real encouraging for people that have quit smoking.

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