Acute chest pain, neck pain and left arm pain – informed consent


• Scene- vitals, 12 lead, assess
• En route-IV, CBG, vitals 12 lead, NTG x1 0.4mg sl
• Hospital- unk


• Response to treatment – the pain would come and go with or without any meds; she never appeared to be in distress.
• Disposition – unk


Mark Shelton Paramedic Woodburn Ambulance


• Chest pain of uncertain etiology.

Differential Diagnosis

• Myocardial infarction
• Gastro-esophageal reflux (GERD)
• Stroke (CVA)
• Aortic aneurysm
• Pulmonary embolism (PE)
• Pneumonia

Patient Workup History

• Patient states – Pain comes and goes quickly, sometimes it feels like heartburn and other times it feels like my heart.
• She is not compliant with gabapentin. States it makes her feel dizzy.

Physical Exam

• GCS-15
• CBG-87


• Gender: Female
• Age: 79 years
• Height: Not Available


• Temperature: Not Available
• Blood Pressure: 156/88
• Heart Rate: 96
• Respiratory Rate: 16
• Pulse Oximetry: 96% RA

Signs and Symptoms

Radiating, L-sided chest pain; shortness of breath.

History Medical

• PHM: Stents, arthritis, HTN, CVA
• Allergies: Allergies-ASA, PCN
• Dispatch info: Difficulty breathing Social
• Lives alone in apt complex


• Amlodipine, gabapentin, B-12

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