I just have a questions that has been bothered me for a long time..Many nursing books talk about performing basic nursing interventions for a chest pain such as oxygen,beta-blocker,nitro (I guess I'm refering to the angina protocol here) I was wondering if some of the interventions are only specific to an ER such as a beta blocker,oxygen or asprin,I'm slightly confused I guess since when I used to work on a step-down unit when ever we used to get a chest pain patient they just gave nitro but I havent see the oxygen,beta-blocker or aspirin for that matter.I also read in the textbook that oxygen should be given as first line defense.
roser13, ASN, RN 6,504 Posts Specializes in Med/Surg, Ortho, ASC. Has 17 years experience. Apr 26, 2010 Any patient in my care who complains of chest pain gets 0's.
bill4745, RN 874 Posts Specializes in ICU, ER. Has 15 years experience. Apr 26, 2010 Always 2L of O2.
GM2RN 1,850 Posts Apr 26, 2010 I agree with the others. At least 2L, maybe more depending...As for the other stuff, if the patient was worked up for chest pain in the ER it should have been initiated there and already included in floor orders unless contraindicated. If the chest pain is a new developement for an admitted patient, then chest pain protocol should be followed, or whatever the policy is at your facility.
celticgirl 28 Posts Specializes in Med surg,. Has 4 years experience. Apr 26, 2010 yep slap on the O2 then ask questions
Meriwhen, ASN, BSN, MSN, RN 4 Articles; 7,907 Posts Specializes in Psych ICU, addictions. Apr 26, 2010 Same here.
XingtheBBB, BSN, RN 197 Posts Specializes in OR, peds, PALS, ICU, camp, school. Has 20 years experience. Apr 26, 2010 I always start O2 before I leave the room to call the MD. I do it in ICU and I did it on the floor. I usually have the morphine in hand and the MI profile drawn or ready before the MD calls back. Usually we give the morphine. If the pt already has it as a prn I go ahead and give it. That was a floor habit, too.Often we skip the B-blockers since our pts often are already hypotensive.
Caffeine_IV 1,198 Posts Specializes in LTC, med/surg, hospice. Has 7 years experience. Apr 26, 2010 Yep..2L of 02 and if they have any IV pain med (Dilaudid or Morphine) I give that before I call the MD.
GilaRRT 1 Article; 1,905 Posts Apr 26, 2010 I do it with the caveat that any patient who is saturating well with a decent A-a will not really benefit from oxygen. Yet, the chart and QA/QI police think otherwise. Beta blockers as immediate interventions have fallen out of favour and I would be careful about administering any agent that will decrease preload suc has a nitrate until I have a XII lead and V4R assuming inferior wall involvement or hemodynamic concerns.
Annisme 161 Posts Specializes in med/surg, ER. Has 3 years experience. Apr 26, 2010 Our ER chest pain protocol: 2LNC, 325 mg asa, notify doc for nitro and morphine orders (MONA). Aspirin is not given if there is a contra-indication (GI bleed, allergy, etc.)
Blackheartednurse 1,216 Posts Apr 26, 2010 Even if the patient states that his pain level is 1 or 2 on scale of 10?
