What do y'all do to assess chest pain, and what do you tell the parent when you call them, in terms of follow-up?
This is possibly the complaint that makes me the most crazy! It's so non specific and could be a thousand things, from the most benign to very serious.
I ask questions to rule out asthma, heart burn, pain r/t coughing, being hit in the chest, any other PMH. I listen to heart, lungs, take vitals. I call the parent to let them know (if I can get them on the phone), but if all is WNL and the kid is still complaining of this nonspecific chest pain, I'm never quite sure what to recommend to the parent. Call Dr? Monitor at home? Send back to class and recheck later? Etc.
I have worked hard to get teachers not to send kids for minor things, but of course saying "my chest hurts" (or "I can't breathe") will get them a trip to the nurse. I have 150 asthmatics, and I feel like their classmates see them getting sent to the nurse for these complaints and decide to try it too. Except, in their case, everything WNL
At my school, I sometimes have a hard time getting parents on the phone, and I don't have physicals for a lot of kids, so I'm often working without the medical history I need. (But that's a separate post!)
I had one "chest pain" who upon auscultation had an irregular rhythm. I asked if there was any problems with his hear that he knew of "Nope." So I call home and they let me know that they just dropped of his 24 hour holter at the cardiologist for the same thing. No one bothered to tell the nurse. He had even wore the thing to school the day before. Very frustrating.
BeckyESRN
1,263 Posts
C'Mon Now!