In a coronary care unit, how do you make the decision to give nitro-vs-morphine for unrelieved cp? The example I am thinking of is a guy who came in thru the ED with CP, no EKG changes, and then continued to have cp. Every two hours he recieved morphine. BP 120s-130s. And what would you expect to see done differently for the same unrelieved cp but with initial EKG changes?
Keep a close eye on them and if it does not relieve call the on call cardi to report. Had one of these guys much like yours. Young (38ish), no initial ekg changes, Morphine prn, and BP good. However, still c/o CP. Called my on call cardi and I guess he was afraid I would call him back at 3am
(hehe) so he swung over and said "lets take him for an investigational cath". Well what do you know he was rolling back through the doors asap and prepping for emergency CABG x 3. So just b/c there is no initial change, does not mean there is not something going on! If the pain does not stop, be vigilant in reassessment and report it!
Last edit by CRIMSON on Oct 5, '11
: Reason: spelling