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clinical practice

Recognising, assessing and managing chest pain

02 January 2022
Features
02 January 2022
Volume 14 · Issue 1

Abstract

Chest pain is a common medical symptom that paramedics attend to in the out-of-hospital environment. The causes of chest pain and the signs and symptoms are explained in this article, alongside tools that could be useful in diagnosis, such as clinical risk scores and troponin testing. Finally, pain management strategies that use a balanced approach for optimal patient care are referred to, with some specificity for cardiac chest pain explained.

Chest pain is a frequently encountered medical condition that paramedics attend to in the out-of-hospital environment (Pittet et al, 2014). It is both a common and threatening problem because in many instances the cause is can be serious, especially if the chest pain had a sudden onset (Bonaca and Sabatine, 2019: 2601).

Chest pain has been defined as pain in the thorax, and can be classified by: its cause, for example by being of cardiac or non-cardiac origin; and its type of pain, for example localised or poorly localised, or pleuritic versus non-pleuritic (National Institute for Health and Care Excellence, 2021).

As heart disease is the leading cause of death in Western nations, it is important that paramedics are able to identify and manage chest pain accurately and according to the risk to the patient (Institute for Health Metrics and Evaluation, 2018). In the paramedic context, identifying risk is an important part of determining the best pathway for patients with chest pain (Best, 2017).

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Chest pain
Acute coronary syndrome
Paramedicine