Communication with the patient and their family members or close ones has an essential role in patient care. In order to create a feeling of safety, it is important that the patient can speak their native language.
A 66-year-old woman comes to the emergency clinic by taxi. She has had odd heart sensations at home, and she’s been feeling unwell. When discussing with the nurse, she says that the squeezing pain in her chest has started two hours earlier.
N: Have you had similar sensations before?
P: Yes, but they have always resolved on their own.
N: Is the pain more intense now?
P: It’s almost the same, or maybe a bit worse than when it first started.
N: Does the pain radiate anywhere?
P: No, it feels just on the chest here.
N: Do you have any heart conditions or other diseases? Are you on any medication?
P: I have hypertension, and I’m on medication for that, and I also have type 2 diabetes. I’m on medication for that too. My blood glucose readings have been good when I’ve checked them at home.
N: Are there heart conditions running in your family?
P: Both my parents have died of heart attack. My dad was 50 and my mom was 60.
N: Have you taken your medications today?
P: Yes, I have.
N: You said that you’ve been feeling nauseous. Have you vomited today?
P: No, but I feel all the time like I’m going to throw up.
N: Do you take nitroglycerin?
P: Yes, and I’ve used the nitro spray twice during the last two hours, but it hasn’t helped.
N: Your blood pressure is normal, and so are your blood sugar, and troponin. The doctor will come and check your ECG and will then decide on the postacute care.
P: What does troponin mean?
N: The troponin value shows a possible heart damage. Your troponin level was normal. Lie on your back now, please, and wait for the doctor.
An EMS unit has arrived at a scene where a 65-year-old woman is suffering from severe chest pain. They are examining the woman’s condition.
Pm: What happened?
P: I have a terrible pain in my chest.
Pm: Can you describe it a bit more, please?
P: It radiates down to my left arm, armpit and throat.
Pm: Does it help if you rest?
P: No, the pain is there no matter what I do.
Pm: Can you describe the pain on a scale of 1-10, ten being the worst possible pain.
P: I would say nine.
FM: Her skin was clammy, and then turned ashen grey.
P: I feel bad and it’s hard to breathe.
Pm: We’ll take care of you. I’ll put an oxygen mask on you.
P: Thank you.
Pm: Now we’ll examine your heart. We’ll connect you to this monitor that shows your heart rate. We’ll also measure your blood pressure and respiration. We’ll take an ECG. Can you lie still and try to relax, please?
P: I can try but I’m not feeling well. It hurts so bad.
Pm: We’ll take care of you, you’re in good hands. We’re going to insert a cannula in the back of your hand, so
you’ll get fluids and medications. I’ll contact the hospital doctor. I’ll give you aspirin and nitro spray.
Pm2: I’ve talked with the emergency doctor. We’ll drive to the hospital right away.
A five-year-old child comes to an ECG examination with a parent. Before the examination the biomedical laboratory scientist has examined the child’s background information.
B: The ECG shows how your heart functions. It doesn’t hurt at all, and you just have to lie still. I will first attach these sticker pads on your chest, wrists and ankles. Then I’ll attach them to the leads, and after that you can just lie still, you can even try to fall asleep.
P: Can I talk then?
B: When I say that “now the examination begins”, you will have to be quiet and relax. Before that you can speak and ask questions.
P: Can my dad stay by my side?
B: Yes, he can. Now you can take your shirt and socks off and go lie down on that bed. Can you take that shirt off
yourself?
P: Yeah.
B: First I’ll cleanse your chest, wrists and ankles with disinfectant and then I’ll attach the sticker pads. Then I’ll attach the leads.
P: When do I have to be quiet?
B: Now you have to be quiet, relaxed and keep your eyes closed, as if you were going to sleep.
B: Breathe in calmly. Now you can open your eyes. I’ll remove the stickers and wipe your skin. Great job. How still you were lying on that examination table! Now you can get dressed.
D: Was this all?
B: Yes, the doctor will give you the results at your next appointment.
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