Medical Emergency - Chest Pain
Scenario: Emergency Room - Acute Chest Pain
A 55-year-old male presents to the ER with sudden-onset chest pain radiating to the left arm, accompanied by diaphoresis (excessive sweating) and shortness of breath. He has a history of hypertension and smoking. The pain started 30 minutes ago while at rest.
Vital Signs:
Blood Pressure: 180/110 mmHg (elevated)
Heart Rate: 105 bpm (tachycardia, irregular)
Respiratory Rate: 22/min (elevated)
SpO2: 94% on room air (slightly low)
Which diagnostic actions should be taken IMMEDIATELY? Select ALL that apply.
Instructions: Select ALL appropriate actions. Actions are weighted differently: CRITICAL actions (3 pts), IMPORTANT actions (2 pts). Incorrect selections result in penalties.
A. 12-lead ECG (electrocardiogram)
CRITICAL - 3 pts
B. IV access and supplemental oxygen
CRITICAL - 3 pts
C. Cardiac biomarkers (troponin, CK-MB)
IMPORTANT - 2 pts
D. Schedule stress test for next week
E. Administer aspirin (antiplatelet therapy)
CRITICAL - 3 pts
F. Order chest X-ray only, no other tests
G. Continuous cardiac monitoring (telemetry)
IMPORTANT - 2 pts
H. Send patient home with antacids

Scoring Method: Weighted Scoring

Maximum Score: 13 points (3+3+2+3+2)
Critical Actions (3 pts each): A, B, E
Important Actions (2 pts each): C, G
Incorrect: D, F (-1 pt penalty), H (-2 pts dangerous choice)
Final Score: (Your points / 13) × 100%

Priority Legend:
CRITICAL Life-saving or time-critical actions
IMPORTANT Essential diagnostic or monitoring actions