Chest Pain in the ED (Resuscitation)

A patient is presented to the ED with chest pain and shortness of breath and the learner is informed of onset of CP/SOB while jogging. The learner must assess the patient’s ABCs and provide initial resuscitation. They must then correctly diagnose PE. This case is successfully completed by treating the patient with thrombolytics–given the clinical diagnosis of PE and the patient’s hemodynamic instability–and handing off the patient to ICU by consultation of Critical Care Medicine for admission. If these critical actions are not done in a timely manner, the patient goes into cardiac arrest and can be rescued once they are given the correct therapies.

Learning Objectives

– Identify a pulmonary embolism based on history, exam, and available data without CT angiography
– Treat the patient with thrombolysis based on clinical instability
– Complete a successful ICU handoff
– Complete treatment and handoff in timely manner and respond appropriately to emergent situations