You attend to a 58 year old female with chest pain.
In addition to data entry, this scenario includes:
• Barcode Scan
• Patient Lookup
Important:
• If not receiving CAD data:
o To create a Practice PCR: Menu > Patient List > Click the Create Practice PCR (second button from right)
o Use Event # E100678321
• Enter your STORY at the top of the screen (comments bubble)
Items marked with an * will auto-populate from CAD in the live Siren system.
*Do not finalize practice PCR’s, when you get to the end, delete the PCR.
The Call: Chest Pain Event (E100678321) |
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Location for Data Entry |
*Event # E100678321 *MPDS determinant 10 - Chest Pain / Chest Discomfort |
Incident > Incident > General |
*10:34 Dispatched code 3 for Chest Pain |
Incident > Times/Details > Times > En Route to Scene |
*Incident location is 1234 Summit Drive, Kamloops |
Incident > Incident Location > Address 1 |
*10:35 - You are en-Route to scene |
Incident > Times/Details > Times > En Route to Scene |
*10:46 – You arrive on scene |
Incident > Times/Details > Times > At Scene |
At Patient’s Side: |
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10:47 - At patients side, inside, upstairs in bedroom. |
Incident > Incident > Incident Location > Location Type |
The patient tells you her name is Mary PatientPatient, 58 years old and she lives at the incident location |
Patient ID > Identification > Patient |
Pt is alert and oriented x 4 |
Primary > Primary Survey |
Patient complains of severe epigastric and substernal chest pain for 20 minutes that came on suddenly while walking up stairs. |
History > Symptoms > Pain |
She has had similar pain before, usually resolves with nitro spray. Patient tried 2 Nitro sprays before calling 911 but no relief. She states that the pain is currently: |
History > Symptoms > Pain |
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History > PQRST/LOTARP |
She appears somewhat pale, clammy. Denies SOB |
Assess/Tx > Assessments > Skin Assessment |
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History > Symptoms > Respiratory > double-tap Shortness of Breath to indicate pertinent negative |
Your partner hooks up the monitor with a 4-lead / NiBP / SpO2. |
Assess/Tx > Procedures > Attach Monitor/AED |
10:50 – Your partner gathers a set of vitals, • Pulse: 100, regular • Resp: 16, normal • SpO2: 96% Room Air • BP: 152/92 • GCS: 15 • Pain: 7/10 |
Vital Signs > Vital Signs > Add New |
10:51 - You give her 2 x 81mg ASA PO and 0.4 mg of nitro SL |
Assess/Tx > Procedures > Drug Therapy *two separate entries, one for each drug |
Her condition improves and there’s no complications with the nitro administration |
Assess/TX > Procedures > SaRC (Drug Therapy) |
10:53 - start an IV N/S TKVO with a 20g in her L forearm |
Assess/Tx > Procedures > Venous/IO/Arterial Access |
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Assess/Tx > Procedures > IV Fluids |
Your partner connects more ECG leads to conduct a 12-lead |
Assess/Tx > Procedures > Attach Monitor/AED |
Upon assessing the chest further you note nothing remarkable visually. |
Assess/Tx > Assessments > Generalized Chest Assessment |
You record the reasons and outcomes from the IV procedure. |
Assess/TX > Procedures > SaRC (IV Fluids) |
You auscultate and find regularity, quality, depth normal |
Assess/Tx > Assessments > Respiratory Quality |
She explains a past Hx of angina, HTN, GERD, osteoarthritis and high cholesterol. |
History > Patient > Past Medical History |
Her current medications include nitro, rabeprazole, ramipril, and Lipitor. |
History > Patient > Current Medications |
At 10:55 Pt states the discomfort is still increasing and feels like pressure, 8/10 |
Vital Signs > Vital Signs > Add New |
She is also starting to become a bit nauseated. |
History > Symptoms > General |
She has one allergy to medication, PCN |
History > Patient > Allergies |
Pt states still no relief with nitro spray |
Assess/Tx > Procedures > Drug Therapy entry for Nitro > SaRC |
You administer 50mg gravol IV, and 2.5 mg morphine IV. |
Assess/Tx > Procedures > Drug Therapy *Two separate entries, one for each drug |
You record 2.5mg morphine wastage. Your partner witnesses the wastage on the PCR |
Review > Signatures & Waivers > Narcotic Wastage |
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Review > Signatures & Waivers > Narcotic Wastage Witness |
The 12-lead shows some Inferior ST elevation. You enter your ECG interpretation: NSR with ST Elevation in Leads II, III, AVF. |
Vital Signs > ECG/Monitor > ECG Interpretation |
Load the pt onto the stair chair and transport her outside to the stretcher. |
Outcomes > Patient Outcomes > Patient Transport Details |
She brings her purse with her |
Outcomes > Patient Outcomes > General |
You get Mary’s BC Service Card, and use the barcode scanner to obtain her information • Mary PracticePractice • DOB: July 07, 1942 • PHN: 987 654 3210 |
Patient ID > Identification > Patient > Menu > Scan *Confirm patient ID before accepting to ePCR |
You use the patient lookup function in Siren |
Patient > Patient Lookup > Enter Information |
The transport destination will be Royal Inland Hospital |
Incident > Incident > Destination |
En Route to Destination: |
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In the back of the ambulance she states minimal relief from the morphine |
Assess/TX > Procedures > Drug Therapy (SaRC) |
10:58 - Current Vitals: • Pulse: 90, regular • Resp: 16, normal • SpO2: 97% Room Air • BP: 140/90 • GCS: 15 • Pain: 7/10 |
Vital Signs > Vital Signs > Add New |
*10:59 – you leave the scene and begin your transport |
Incident > Times/Details > Times > En Route to Destination |
You admin another 2.5mg of morphine IV to good effect. |
Assess/TX > Procedures > Drug Therapy |
After 5 minutes her pain is reduced to 3/10 |
Vital Signs > Vital Signs > Add New |
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Assess/TX > Procedures > SaRC (Drug Therapy) |
You transport her to RIH, hot, and notify the hospital en route of the STEMI |
Incident > Incident > Mode |
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Vital Signs > ECG / Monitor > ECG Interpretation |
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Vital Signs > ECG / Monitor > ECG Interpretation (Transmission > STEMI > Flagged Clinically Suspected) |
You enter in her Chief Complaint |
History > Patient > Complaints |
You enter your Provider’s Impression |
Impressions > Impressions > Providers Impression |
At Destination: |
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*11:10 - You arrive at Royal Inland Hospital Print your Admitting Report |
Incident > Times and Details > Times |
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Review > Print Preview > Admitting Report |
While waiting at triage, you enter your narrative in the comments section |
Comments > Add Narrative |
11:24 - You detach the monitor |
Assess/Tx > Procedures > Attach Monitor |
*11:25 - You transfer care of your patient to an RN in the main department |
Incident > Times and Details > Times |
Use the required function to complete your PCR |
Review > Required |
You finalize the report prior to printing |
Review > Print Preview > Finalize |
You print the Patient Care Report and give it to the RN |
Patient List > View Report > Print Preview > Patient Care Report |
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Review > Print *After finalizing, you will be taken to the Patient List |