What would you do if a patient comes in with chest pain?

[Tedstar]

Quick question: I have received many different things nurses would do on a step-by-step basis when patients come in with CP in an urgent care. I know the interventions are based on the symptoms and gauging the cares would be based on the patient’s presentation/acuity of symptoms. However, I know there is like a 5 minute window from chest pain complain to getting an EKG. So my question is, What would you do if a patient comes in with chest pain- what would you do from first to last? I’m just not sure of how/when to obtain the medical history vs getting VS/EKG.

[MunoRN, RN]

If by "urgent care" you mean a stand-alone urgent care clinic then you should send them to an appropriate hospital ER.  Vitals and a 12 lead should be obtained and interpreted if the urgent care clinic has the ability to do so, a STEMI should go to a PCI capable hospital by ACLS transport.  There should be protocols in place that determines whether the patient with ACS symptoms but without a STEMI should be directed to go to an hospital ER by private car or ambulance.

[Hannahbanana, BSN, MSN]

This is not one of those questions where there is only one priority, because you can do several at once. VS, ASA and O2 if you have a protocol, EKG and send via tele to somebody who knows how to read it, and on the bus c ACLS EMS to a real ED.
Never put a chest pain pt in a private car. That “negative for ischemia” EKG may be hiding a dissecting thoracic aneurysm, slowly-accumulating pneumothorax, or something else too. 
The differential dx for CP does include some benign things but the risk of consequences for missing the non-benign ones is too great to screw around. Turf to higher level of care ASAP.