Step-by-step: Chest pain

Chest pain (Non-traumatic):

1. Upon arrival on scene perform EMCAP.

2. Form a general impression of the patient, noting LOA, positioning, work of breathing, and skin colour/condition.

3. Perform the primary survey, noting LOA, airway patency, respiratory rate and work of breathing, and assessing pulse for rate, rhythm and strength, as well as cap refill. Correct life threats prior to continuing with assessment.

4. Obtain HPI, PMHx, Medications, Allergies, and last ins/outs.

5. Perform baseline vital signs and 12-lead ECG.

6. Perform physical assessment of the chest, including auscultation.

7. If cardiac cause is suspected administer ASA and Nitroglycerine as per ALS PCS guidelines.

8. If patient is STEMI positive, place defibrillator pads immediately and initiate bypass provided that criteria are met.

9. Notify the Cath lab upon departure.

10. Continue to monitor en-route to the ED, and consider additional treatments as appropriate.