Chest pain
Posted: July 27, 2011 Filed under: Podcasts | Tags: chest pain, em, emergnecy medicine 4 Comments »Chest pain- its one of the most common chief complaints in the ED and we need to be the experts on this. This podcast reviews how to get a good history of the patient’s chest pain, the relevant physical exam findings, how to work it up, and how to talk effectively to your consultants. Please email your comments and suggestions to steve@embasic.org
Chest pain show notes (Word document)
I was rocking out to some EM Basic on my drive to Houston and I would like to leave some feedback.
1. You tried to include too many things in detail into one lecture and cut out some other pertinent data. i.e. Instead of trying to include everything that causes chest pain in one lecture and all about them, maybe focus one lecture on each aspect in much more detail. For instance, you talked about chest pain and didn’t talk about features of the H&P increase/decrease the likelihood of ACS versus something else
2. Why does everyone with need an ECG and chest x-ray? I would say that applies to all of the low to very low risk patients, but not the “no risk” patients. Thoughts?
3. Stop talking about what “some staff” do and stick to what your plan will be in <11 months.
Hey Steve
Thanks for listening and the feedback- I really appreciate it.
Going by your points
1) I do plan on making a podcast in the future dedicated to MI/ACS and you’re right- I could have gone into a little more detail on MI/ACS and the history since that is what we are concerned with the most. For this first episode, I wanted to make sure to hit the 6 deadly causes of chest pain as an intro and save the greater detail for a later lecture
2) I agree- there are probably some patients out there with “no-risk” chest pain who don’t need an EKG and chest x-ray. For example, that 10 year old who just got punched in their chest by their older brother probably doesn’t need a chest-xray or EKG. However, as a medical student/intern (the main target of the podcast) I think the safest thing for them to say is that everyone needs an EKG and chest x-ray when you are starting out. Once you have more experience, you can start talking about these no-risk patients and not getting an EKG/CXR on everyone.
3) Good point- I mention those caveats to help people realize that there are different ways of doing things and that their attendings/staff may want a different management strategy from what I suggest. I’m far from an authority on emergency medicine so I won’t be claiming to be an expert anytime soon.
Thanks for listening and have fun in Houston- you’ll see and learn a lot…
Steve
Excellent work Steve, I’m very impressed. You have surpassed many of your peers and were glad to have you as one of our physicians. Keep up the good job.
~Cowboy
Thanks Cowboy…that means a lot…in return, I won’t nickle and dime you on my next shift…sound good?