When to send a chest pain to the ER

[w3ndiscott]

:redbeatheI am a brand new nurse, just graduated 2mths ago. I am working at a nursing home. I love my job, I never thought I'd want to work with the elderly but I love my residents. I am learning something new everyday. I've got my everyday routine down really well, it's when something out of the ordinary happens and I hear someone yell "Go get the nurse" that I say to myself "Oh crap!" My question is one of the things I deal with a lot are chest pains. I'm always having residents complaining of chest pains, it is kind of routine. But I don't really know what to do when it happens. I take the vitals, assess, look for SOB, ask them to describe the pain. (Thank goodness none of them have been heart attacks yet) But I don't know at what point to get concerned something is really wrong. At what point do I call the hospital and have them sent out? I'd appreciate any advice on this.:redbeathe

[Natingale, EdD, RN]

Im in my second year of nursing school, i would ask another nurse after you've done your assessment, and/or call the doctor!

[NC Girl BSN]

I worked in a LTC facility almost 2 years and most if not all have some type of cardoivasular hx. I would do all the assessment you describe and see if they have nitroglycerin ordered PRN. If so, initiate that and see if it works. It could also be gas or indigestion. If you think its that then you might want to give an antiacid. It they are sweaty and vitals are crazy, SOB, 02 sat out of whack, then I would call the Supervisor or MD. Make sure you know their Code Status because if they are a DNR, the MD or family might not want anything done. It could be angina and in that case you could give 02 and nitroglycen to relieve. When all else fails call another nurse to advise.