Critical Thinking

This patient may be having chest pain as a result of angina. This is usually caused by physical exertion and the diminished amount of oxygenated blood to the heart. Although the oxygen is never completely cut off, the pain arises from the muscles not having adequate oxygen or blood circulating in that area. Since the patient was playing flag football, it is likely that he over exerted himself. The pain will usually stop once the activity ceases and the patient rests. Those with diagnosed angina will usually be prescribed nitroglycerin which helps increase the circulation of blood and oxygen to the heart. (Badour & Bergeron, 2011)

Being the only EMR at the scene, it would be advisable to get the patient to obtain his vital signs first, then determine what caused the onset of the symptoms. It would also be advisable to see if the pain is radiating outward, down the arm and how severe the pain is. It would also be advisable to ask this patient if he has had attacks like this before and has he been prescribed nitroglycerin before, as well as does he take any other medications. Since there is no supplemental oxygen available, the EMR should advise the patient to breathe slowly, taking deep breaths but not so deep as to get too much oxygen in his system. He should continue to rest while the EMR monitors his vital signs. (Badour & Bergeron, 2011)

Even though the patient states he is feeling better after a time, angina can mimic heart attack symptoms so it would be best that he be taken into the emergency to monitor his heart for cardiac arrhythmia and to run a cardiac enzyme test since this is one of the best ways to tell if there is a heart attack occurring. (Badour & Bergeron, 2011) Furthermore, the doctor can run a stress test on the patient and perhaps use a Holter monitor which records the hearts rhythms for 24-48 hours. The EMR should then call for an ambulance to transport the patient to the nearest emergency room. If he refuses further