Hi, so I have a long question about a pt I triaged the other night and was hoping to get some insight from some experienced nurses. On a side note, I've been an ER nurse for almost 2 years, only been doing triage for the past few weeks. I have a doctor at work who is very hard on me, so when I was triaging this particular pt, I heard his voice in my ear. A 20 year old male came in c/o chest pain x2 days. Denied SOB, nausea, vomiting, pain going down left arm or up his chin/neck,said pain 5/10. when I asked him where his pain was he pointed straight to his epigastric region, right under his sternum. I asked him several different ways, the pain was not in his chest, not on the left side of his chest, right in the epigastric. He had dusky colored fingers, when I asked him about this he said his hands were always cold and looked like this in the winter. Because of this I was not able to get a SPO2, but I palpated a pule of about 70. He had no complaints of his hands, because as he put it this was normal. I put chief complaint as "abd pain" and put him at ESI of 3. I wrote in my initial note that pt was c/o of "chest pain" but that he pointed to his epigastric region, that it was ongoing for 2 days, and denied other symptoms. I told the charge nurse, it was change of shift, and then told the oncoming dr what was going on. The pt waited longer than I guess the mother thought he should have given that he said chest pain, she though he should've had a ECG immediately. When the other nurse told her that he was put down as abd pain she was angry that he was not in as chest pain. Now this would have been the case had I put chest pain down at the complaint, but I did not think it really was. So my question, is would you have put chest pain down because that's what the pt said, or when I did my assessment and thought it was abd, would you have put that down? Also would the raynauds have had any play, and that I didn't get an SPO2 initially? The doctor that was oncoming gave me a problem on a previous night because I put down chest pain because that was what the pt said, when it was really epigastric pain. I'm still learning and looking for input.
