PubMed Health⌕ Search
Home/Archive/PubMed

PubMed · 7630664

Chest pain: developing rapid assessment skills.

H E Scher
View original source ↗Export metadata ↓

Abstract

Chest pain is a common complaint among adult patients. Chest pain may be a signal of an impending life-threatening event. The accurate assessment of chest pain is difficult. The responsibility of identifying a potentially life-threatening condition accompanied by chest pain presents the nurse with an incredible challenge. Chest pain may be caused by a variety of cardiac, respiratory, gastrointestinal and musculoskeletal illnesses. A complete, thorough history that includes family history and risk factors is the most important part of the assessment. The history is followed by the physical assessment. This phase of the assessment process may include important tests such as a chest X-ray, 12-lead electrocardiograph and cardiac isoenzymes. A perceptive and observant nurse with astute assessment skills will set the tone for optimal patient treatment leading to a more positive outcome for the patient.

Explore related subjects

Chest PainDiagnosis, DifferentialHumansNursing AssessmentRisk FactorsJournal Article

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

H E Scher. Chest pain: developing rapid assessment skills.. https://doi.org/10.1097/00006416-199505000-00007

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2007

Impact of a negative prior stress test on emergency physician disposition decision in ED patients with chest pain syndromes.

OBJECTIVE: Many emergency department (ED) patients with potential acute coronary syndromes (ACS) have prior visits and prior cardiac testing; however, the effect of knowledge of prior testing on the emergency physician disposition decision making is not known. We studied the impact of prior noninvasive testing (ie, stress testing) for myocardial ischemia on disposition decision making in ED patients with potential ACS. METHODS: We performed a prospective cohort study of ED patients with chest pain who received an electrocardiogram for potential ACS. Data included demographics, medical history, stress test history, and TIMI risk score. Patients were followed in-house; 30-day telephone interviews were performed for follow-up. Main outcomes were ED disposition (admit/discharge) and a composite of 30-day death, acute myocardial infarction, and revascularization stratified on the basis of prior stress testing known at the time of presentation. Standard statistical techniques were used with 95% confidence intervals (CI). RESULTS: There were 1853 patients enrolled and 97% had follow-up. Patients had a mean age of 53 +/- 14 years; 60% were women, 67% were black. There were 1491 (79%) patients without a prior stress test, 291 (16%) had a normal prior stress test result, and 89 (5%) had an abnormal prior stress test result. Admission rates were 92% (95% CI, 87%-98%) for patients with a prior abnormal stress test, 73% (95% CI, 67%-78%) for patients with a normal prior stress test, and 70% (95% CI, 67%-72%) for patients without a prior stress test. Adverse outcomes were the highest among patients with prior abnormal stress test but did not differ significantly between patients with no prior stress test and patients with prior normal stress test (10.1% [95% CI, 3.6-16.7%] vs 5.2% [95% CI, 4.1-6.4%] vs 4.8% [95% CI, 2.4-7.3%]). CONCLUSION: Patients without prior stress tests and patients with prior normal stress tests were admitted for potential ACS at the same rate and had the same 30-day cardiovascular event rates. This suggests that prior stress testing does not affect subsequent disposition decisions. Perhaps cardiac catheterization or computed tomography coronary angiograms would have more of an impact on subsequent visits, making them potentially more cost-effective in the low-risk patient.

Chest Pain↗
PubMed2007

Hypothesis: chest pain in primary spontaneous pneumothorax.

The mechanism of chest pain in spontaneous pneumothorax has never been discussed in the literature. It is proposed that this is due to acute parietal pleural irritation secondary to leakage of inflammatory material following bleb rupture, rather than the presence of interpleural air.

Chest Pain↗