Chest Pain in the ED (ACLS)

Jason Smith is a 45 year old man who is presenting to the Emergency Department with chest pain and shortness of breath. Participant is informed via EMR triage note on VR tablet of patient’s intake vitals and very brief HPI of onset of chest pain and shortness of breath while jogging. Initially, participant must assess ABCs of patient and provide initial resuscitation. In subsequent states, participant must use history, exam, labs, normal CXR, and bedside US showing right heart strain to correctly diagnose PE. Finally, case is successfully completed by treating patient with thrombolytics (given the clinical diagnosis of PE and patient’s hemodynamic instability) and disposition of patient to ICU by consultation of Critical Care Medicine for admission – if this is not done in timely manner, patient goes into cardiac arrest, but can be rescued given correct therapies.

Learning Objectives:

Identify a pulmonary embolism based on history, exam, and available data without CT angiography and treat with thrombolysis based on clinical instability