nymedic9999
Forum Probie
- 21
- 1
- 3
Who here would give ASA to a 19 year old with unexplained chest pain ( anxiety not suspected)
19 year old chest pain.
- Thread starter nymedic9999
- Start date
ERDoc
Forum Asst. Chief
- 546
- 616
- 93
Any history of early heart disease?
nymedic9999
Forum Probie
- 21
- 1
- 3
None known in the family. Patient is female complaining of pain radiating into her neck. Vitals were stable. Pain started while driving. Pulled over called 911
ERDoc
Forum Asst. Chief
- 546
- 616
- 93
Nope, no aspirin.
nymedic9999
Forum Probie
- 21
- 1
- 3
I just learnt about Reyes syndrome the other day on a call and was wondering.
ERDoc
Forum Asst. Chief
- 546
- 616
- 93
Reye's is not really a concern in this pt. You will rarely see it after 18y/o and the most common age is between 5 and 14.
http://emedicine.medscape.com/article/803683-overview
http://emedicine.medscape.com/article/803683-overview
floridamed224
Forum Crew Member
- 49
- 3
- 8
I would give him Aspirin. It won't hurt him as long as he isn't allergic. Per protocol where I work: Call for ALS, Administer Aspirin, Administer Oxygen. Of course absent any contraindications.
COmedic17
Forum Asst. Chief
- 912
- 638
- 93
It sounds to me like a pulmonary embolism is more likely in a 19 year old female. Probably on BC. PE pain can radiate. Did you put her on capno?
Jim37F
Forum Deputy Chief
- 4,300
- 2,876
- 113
Legitimately curious, why is 19 years old a contraindication for aspirin?
COmedic17
Forum Asst. Chief
- 912
- 638
- 93
NSAIDS have been linked to higher risk of causing both DVT/PE. A 19 yo female is far more likely to throw a PE then an MI.
- 4,513
- 3,239
- 113
The age isn't a contraindication. Its just that this patient is highly unlikely to be having a CAD event.
- 7,846
- 2,801
- 113
Can't really hurt is very poor justification for treatment.
floridamed224
Forum Crew Member
- 49
- 3
- 8
Good thing I didn't say it "Can't really hurt". I said it won't hurt him. The age is not a contraindication.
medichopeful
Flight RN/Paramedic
- 1,863
- 255
- 83
Is that the protocol for any chest pain? Or only of suspected or confirmed cardiac origin?
- 7,846
- 2,801
- 113
Fair enough. So then what's your justification then? Oral glucose won't hurt him either, shall we give that too?
Sure, age is not a contraindication. So what is the indication here?
Hand the 12 lead to your partner first
RocketMedic
Californian, Lost in Texas
- 4,997
- 1,462
- 113
Oddly enough, I recently transported a 17 y/o with a 2mm STEMI in II,III,AvF and a tryponin of 3.43, so it's certainly possible. Unlikely, but that's why we have the fancy magic boxes.
DesertMedic66
Forum Troll
- 11,271
- 3,452
- 113
yes it is unlikely that it is a cardiac event: but you can't say that for sure: (unless there is a known trauma event leading up to the chest pain {IE base ball to the chest}): we don't have blood work up in the truck, nor chest x-ray capability: An ED won't make that decision on a 12 lead only.
Yes it can be a PE, but without a complaint of difficulty breathing or travel, etc then that is hard to make that decision also.
Treat it like it is a cardiac event and transport. Hate to be the crew that takes a patient into the ED having chest pain that you ignored because they are too young to be having an MI, and find out later that the patient had a MI.
Yes it can be a PE, but without a complaint of difficulty breathing or travel, etc then that is hard to make that decision also.
Treat it like it is a cardiac event and transport. Hate to be the crew that takes a patient into the ED having chest pain that you ignored because they are too young to be having an MI, and find out later that the patient had a MI.