19 year old chest pain.

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nymedic9999

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Who here would give ASA to a 19 year old with unexplained chest pain ( anxiety not suspected)
 
Any history of early heart disease?
 
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
 
Nope, no aspirin.
 
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.
 
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?
 
Legitimately curious, why is 19 years old a contraindication for aspirin?
 
Jim37F said:
Legitimately curious, why is 19 years old a contraindication for aspirin?
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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.
 
futuremed224 said:
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.
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Can't really hurt is very poor justification for treatment.
 
Tigger said:
Can't really hurt is very poor justification for treatment.
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Good thing I didn't say it "Can't really hurt". I said it won't hurt him. The age is not a contraindication.
 
futuremed224 said:
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.
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Is that the protocol for any chest pain? Or only of suspected or confirmed cardiac origin?
 
futuremed224 said:
Good thing I didn't say it "Can't really hurt". I said it won't hurt him. The age is not a contraindication.
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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?
 
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.
 
RocketMedic said:
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.
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Had that exact call during internship

IMG_2490.JPG
 
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.
 
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