What are the rest of his vital signs? What is his usual BP? How does he feel? Was this found on routine vital sign check or is something wrong?

Cardiac:  –Tachyarythmia  –Bradycardia  –MI Physiologic:  –ESLD, CHF  –Young and asleep Sepsis Meds Hypovolemia:  –Dehydration  –Bleeding

See the patient Call your resident; Call MICU Recheck vital signs, check orthostatics IV Fluids Get Access Consider EKG, CBC, T&S, Broad spectrum ABx

What are her vital signs? How do her lungs sound? What are her IV Fluids?

Reactive Airway Disease/COPD PE Cardiogenic –MI, CHF Too much IV Fluid Pneumonia PTX Anxiety

Examine patient –listen to lungs, JVP, LE Edema CXR EKG; cardiac enzymes ABG I/Os On DVT prophylaxis?

Oxygen Diurese Chest CT r/o PE Nebulizer/BIPAP Head of bed up Nitro Call resident

What are his vital signs (check both arms)? How does he look? When did it start? Get an EKG

MI/aortic dissection GERD PE Anxiety MSK Pneumonia; cholecystitis; pancreatitis Pericarditis

Evaluate patient Treat as angina-tele, ASA, B-blocker, nitro, serial CKs, heparin, tell resident Treat as GERD-mylanta Treat as MSK-ibuprofen Treat as anxiety-reassure; ativan? Treat as PE –chest CT, heparin?, oxygen  Treat as dissection – CT chest, control BP