Room Questions for ER Doctors

I want to personally know the answers to these questions to help better educate our ER doctors today about how to detect AorticDissections. I want to know from the ER doctor's themselves if they had a loved one, such as a brother or sister, what they would be looking for if they were with them at the time of the Emergency and were at a completely different facility than their own ER department. What "clues/keys" would they be making sure the ER doctor's working on their brother or sister would be doing? What tests?

Here's some questions that I want answered:

1. What if a man/woman 45 years of age came into your ER department complaining of chest pains. What would be the first things you would do to begin to rule of the possibility of an AorticDissection?

2. Is there a check list that you would use to differentiate from these?

3. How would you be able to rule out that it was not a heart attack?

4. How would you rule out that it was not a pulmonary embolism?

5. Would there be clues like, different BP readings that you detect that might start you thinking down the possible AD path? Intense Back pain between shoulders? Numbness in limbs?

6. Would you act differently if the patient or loved one with them said you had a history of AorticDissection's in the family? Would you go to the CT scan immediately versus still trying to determine if it was a Heart Attack?

7. Would there be a particular blood test such as a D-Dimer that you would run? What if it did come back high for a Pulmonary Embolism? Would  you order a CT right away?

8. Do you feel that you have had adequate training on the subject of Aortic Dissections to be able to properly detect it if it was your loved one you were working on?

9. What gives you the "green" light to order a CT scan as you since your patient might be suffering from an ascending aortic dissection?

10. How often do you get refresher course on the subject? Who provides them? How many AD's have you detected before? Did you use that check list as mentioned before? Have you changed your procedures on the ability to detect these based on what you have learned in the past?

I look forward to your reply and putting the answers out on my site to help others be prepared in case they are in an ER room where they might feel something is not being done or is being missed, perhaps they can refer to these questions to get the "light bulb" turned on with the ER doctor to consider that it might just be an aorticdissection his or her loved one is suffering from!


Brian S. Tinsley
Phone: 206-550-7957
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