Location: You are an FY1 on medical ward cover. The ward sister has bleeped you to see a patient
Patient: 55 year old man has developed central crushing chest pain
Task: – Take a focused history from the patient – Perform a full ACDE assessment, a nurse will be available to help you with investigations or management that you require. – After 6 minuets you will be asked a series of questions by the examiner. – Answer any questions that the patient may have
Note to actor: Try to restrain yourself from volunteering to much information – you may do so when prompted (that is, by a specific question, not a general one). If a student is on the wrong line of clinical reasoning do not fuel this line of thinking, state no to the question as being ambiguous may prompt further questioning and does not allow the student to be appropriately tested. The aim of the exercise is to take a focused history; short answers are required.
Central crushing chest pain came on 1 hour ago. Pain is a 10/10, radiates to jaw and left shoulder. You have not experienced anything like this before. You feel sweaty and terrible like you are going to die. You have vomited once and feel incredibly nauseous.
PMH = hypertension, type 1 diabetes
DH = novorapid, levemir insulin
No known drug allergies