Mrs Georgopoulos arrived at the Emergency Department at 1130 hrs with central crushing chest pain radiating to her jaw since 1100 hrs. Findings from the 12 lead ECG recorded by paramedics showed ST elevation in leads V2, V3, V4. Aspirin 300mg administered on route to hospital.

Background: Hypertension (Captopril 12.5mg bd); Hyperlipidaemia (Simvastatin 40mg nocte); Type 2 Diabetes Mellitus (DM) (diet controlled) and Allergy – Penicillin.

Assessment:

-Airway patent

– Breathing: Respiratory rate 24, bilateral air entry, breath sounds clear. SpO2 on room air 91%

– Circulation: Sinus Tachycardia 120 bpm. BP 110/60. Diaphoretic and peripherally cool. Central crushing chest pain radiating to the jaw.

COLDSPA:

Character: crushing chest pain

Onset: 11am

Location: Central, radiating to jaw

Duration: ongoing

Severity: 8/10

Pattern: at rest, not relieved by SL Anginine Spray x 2

Associated symptoms: diaphoresis

Disability: Alert