Chest Pain Assessment
Nursing Critical Thinking Branching Scenario
Start
Learning objectives
Learners will be able to:
- Apply critical thinking in chest pain assessment
- Demonstrate proper nursing prioritization
- Interpret basic ECG findings
- Communicate effectively with patients
- Recognize importance of rapid response
Continue
You’re a registered nurse in the Emergency Department at Community General Hospital. It’s a busy Tuesday morning, and patients are steadily arriving. As the triage nurse, you’re the first to see each person who walks in.
Continue
John Miller, 58 years old, approaches the desk. He looks anxious and holds his chest with one hand. “It started about 45 minutes ago while I was bringing in groceries,” he says.
Continue
Your task is to:
- Complete a focused initial assessment
- Decide the next nursing steps
- Prioritize actions and communicate effectively
Remember: Every minute counts in possible cardiac emergencies.
Begin Assessment
Let's take a look at his initial assessment and vital signs.
Next
Excellent Priority Choice
Ordering an ECG within 10 minutes of arrival follows best practice.
No delay (10 minutes since arrival)
Status: Stable (94 bpm, SpO₂ 96%)
Next
Not quite
Rreassurance alone won’t reveal heart instability.
+10 min (Total time: 20 minutes)
Status: HR 108 bpm | BP 156/94 | Skin clammy
Next
Helpful, but not the main priority
History is important, but it shouldn't delay the ECG. Your detour means John’s pain worsens and HR increases.
+5 min (Total: 15 min)
Status: HR 100 bpm | BP 150/92 | Skin pale
Next
Thorough, but not timely
You perform a thorough pain assessment — strong skill, but it takes time. When a heart attack is suspected, every minute counts. Getting the ECG quickly is more important than collecting extra pain details.
+2 min added - Elapsed time now 12 min
Status: Stable (94 bpm, SpO₂ 96%)
Next
You’ve completed Mr. Miller’s initial assessment and noted his vital signs and appearance. What’s your next best action?
Perform PQRST pain assessment
Initiate a 12-lead ECG
Obtain medication and cardiac history
Reassure patient and have him sit in a wheelchair while you notify the provider.
Elapsed Time: 10 minutes since arrival
You act immediately, preparing and attaching a 12-lead ECG.
Nice work! AHA/ACC Chest Pain Guidelines (2021) state that you should obtain a 12-lead ECG within 10 minutes of the patient's arrival. While the leads are placed, you continue a focused pain assessment to correlate findings.
Elapsed Time: 10 minutes since arrival
Status: HR 94 | BP 148/90 | SpO₂ 96% | Anxious but stable
View ECG Results
Elapsed Time: 12 minutes since arrival
You complete your focused PQRST assessment.
Mr. Miller describes 8/10 substernal pressure radiating to the left arm, starting about 45 minutes ago while walking to his car. You recognize these as red-flag features of cardiac pain and immediately prepare to obtain a 12-lead ECG.
Elapsed Time: 12 minutes since arrival
Status: HR 92, BP 148/90, SpO₂ 96%, Pale but alert
Begin ECG
Elapsed Time: 15 minutes since arrival
You spend several minutes obtaining Mr. Miller’s medication and cardiac history.
His pain rises to 9/10, and his heart rate increases as you gather details. You now prepare for a 12-lead ECG, recalling that the AHA/ACC Chest Pain Guideline (2021) recommends obtaining it within 10 minutes of arrival to identify ischemic changes early.
Elapsed Time: 15 minutes since arrival
Status: HR 100 | BP 150/92 | Skin pale | RR 24
Start ECG
Elapsed Time: 20 minutes since arrival
Critical Delay.
While you reassure Mr. Miller, his pain intensifies to 10/10.He clutches his chest, breathing rapidly and diaphoretic. You recall that the American Heart Association and Emergency Nurses Association emphasize obtaining a 12-lead ECG within 10 minutes of presentation for any patient with possible cardiac chest pain (AHA/ACC 2021 Chest Pain Guideline; ENA Triage Standards). Delays beyond this window increase the risk of missed STEMI recognition and poorer outcomes.
Elapsed Time: 20 minutes since arrival
Status: HR 108 | BP 156/94 | Skin clammy | RR 26
You spend several minutes obtaining Mr. Miller’s medication and cardiac history.
His pain rises to 9/10, and his heart rate increases as you gather details. You now prepare for a 12-lead ECG, recalling that the AHA/ACC Chest Pain Guideline (2021) recommends obtaining it within 10 minutes of arrival to identify ischemic changes early.
Elapsed Time: 20 minutes since arrival
Status: HR 100 | BP 150/92 | Skin pale | RR 24
Start ECG
Start ECG
20 minutes
Time elapsed since arrival:
Click on the ECG strip to review the findings. Based on these results, what do these changes indicate?
Nonspecific ST-T changes
Inferior STEMI (leads II, II, aVF)
Lateral wall ischemia
Artifact - Repeat ECG later
22 minutes
Time elapsed since arrival:
Click on the ECG strip to review the findings. Based on these results, what do these changes most likely indicate?
Nonspecific ST-T changes
Inferior STEMI (leads II, II, aVF)
Lateral wall ischemia
Artifact - Repeat ECG later
25 minutes
Time elapsed since arrival:
Click on the ECG strip to review the findings. Based on these results, what do these changes most likely indicate?
Nonspecific ST-T changes
Inferior STEMI (leads II, II, aVF)
Lateral wall ischemia
Artifact - Repeat ECG later
30 minutes
Time elapsed since arrival:
Click on the ECG strip to review the findings. Based on these results, what do these changes most likely indicate?
Nonspecific ST-T changes
Inferior STEMI (leads II, II, aVF)
Lateral wall ischemia
Artifact - Repeat ECG later
20 minutes
Time elapsed since arrival:
After confirming the ECG shows ST elevation in leads II, III, and aVF, what is your priority nursing action?
Begin documenting the ECG findings and reassess vital signs.
Contact the on-call provider to report the ECG findings immediately.
Place the patient on 2 L/min oxygen and obtain a pain reassessment.
Call for another nurse to verify the ECG before escalating.
22 minutes
Time elapsed since arrival:
After confirming the ECG shows ST elevation in leads II, III, and aVF, what is your priority nursing action?
Begin documenting the ECG findings and reassess vital signs.
Contact the on-call provider to report the ECG findings immediately.
Place the patient on 2 L/min oxygen and obtain a pain reassessment.
Call for another nurse to verify the ECG before escalating.
25 minutes
Time elapsed since arrival:
After confirming the ECG shows ST elevation in leads II, III, and aVF, what is your priority nursing action?
Begin documenting the ECG findings and reassess vital signs.
Contact the on-call provider to report the ECG findings immediately.
Place the patient on 2 L/min oxygen and obtain a pain reassessment.
Call for another nurse to verify the ECG before escalating.
35 minutes
Time elapsed since arrival:
After confirming the ECG shows ST elevation in leads II, III, and aVF, what is your priority nursing action?
Begin documenting the ECG findings and reassess vital signs.
Contact the on-call provider to report the ECG findings immediately.
Place the patient on 2 L/min oxygen and obtain a pain reassessment.
Call for another nurse to verify the ECG before escalating.
Time elapsed since arrival:
23 minutes
You prepare to call Dr. Lee about Mr. Miller's condition. Write your report in the Padlet below using the SBAR framework to report clearly and quickly. Your communication can change the outcome.
Next
You prepare to call Dr. Lee about Mr. Miller's condition. Write your report in the Padlet below using the SBAR framework to report clearly and quickly. Your communication can change the outcome.
Time elapsed since arrival:
27 minutes
Next
Time elapsed since arrival:
32 minutes
You prepare to call Dr. Lee about Mr. Miller's condition. Write your report in the Padlet below using the SBAR framework to report clearly and quickly. Your communication can change the outcome.
Next
Time elapsed since arrival:
39 minutes
You prepare to call Dr. Lee about Mr. Miller's condition. Write your report in the Padlet below using the SBAR framework to report clearly and quickly. Your communication can change the outcome.
Next
Time elapsed since arrival:
23 minutes
Now it's time to rate your SBAR Report
In a real clinical situation, every second counts. When communication isn’t clear, time is lost — the provider may have to ask follow-up questions, confirm details, or clarify your concern before acting. In this reflection, you’ll review your SBAR report to Dr. Lee and rate how clearly you communicated each part of the SBAR framework: Situation, Background, Assessment, and Recommendation. For every section that was vague, incomplete, or unclear, extra minutes will be added to your total elapsed time — representing the delay in patient care that results when the message isn’t concise or complete. By the end, you’ll add up your total time to see how your communication affected the patient’s outcome.
Next
Time elapsed since arrival:
27 minutes
Now it's time to rate your SBAR Report
In a real clinical situation, every second counts. When communication isn’t clear, time is lost — the provider may have to ask follow-up questions, confirm details, or clarify your concern before acting. In this reflection, you’ll review your SBAR report to Dr. Lee and rate how clearly you communicated each part of the SBAR framework: Situation, Background, Assessment, and Recommendation. For every section that was vague, incomplete, or unclear, extra minutes will be added to your total elapsed time — representing the delay in patient care that results when the message isn’t concise or complete. By the end, you’ll add up your total time to see how your communication affected the patient’s outcome.
Next
Time elapsed since arrival:
32 minutes
Now it's time to rate your SBAR Report
In a real clinical situation, every second counts. When communication isn’t clear, time is lost — the provider may have to ask follow-up questions, confirm details, or clarify your concern before acting. In this reflection, you’ll review your SBAR report to Dr. Lee and rate how clearly you communicated each part of the SBAR framework: Situation, Background, Assessment, and Recommendation. For every section that was vague, incomplete, or unclear, extra minutes will be added to your total elapsed time — representing the delay in patient care that results when the message isn’t concise or complete. By the end, you’ll add up your total time to see how your communication affected the patient’s outcome.
Next
Time elapsed since arrival:
38 minutes
Now it's time to rate your SBAR Report
In a real clinical situation, every second counts. When communication isn’t clear, time is lost — the provider may have to ask follow-up questions, confirm details, or clarify your concern before acting. In this reflection, you’ll review your SBAR report to Dr. Lee and rate how clearly you communicated each part of the SBAR framework: Situation, Background, Assessment, and Recommendation. For every section that was vague, incomplete, or unclear, extra minutes will be added to your total elapsed time — representing the delay in patient care that results when the message isn’t concise or complete. By the end, you’ll add up your total time to see how your communication affected the patient’s outcome.
Next
Time elapsed since arrival: 23 minutes
Review your SBAR report to Dr. Lee by flipping through the following cards.
Add the minutes from each card to your total elapsed time
View SBAR Report
🟢 Yes — I stated it clearly and right away. (add 0 min)🟡 Somewhat — I mentioned the issue but missed details. (add +1 min) 🔴 No — I jumped straight into data without context. (add +2 min)
🟢 Yes — I stated it clearly and right away. (add 0 min)🟡 Somewhat — I mentioned the issue but missed details. (add +1 min) 🔴 No — I jumped straight into data without context. (add +2 min)
Yes — I shared all key details. (add 0 min)Somewhat — I mentioned a few but not all. (add +1 min) No — I left out important background. (add +2 min)
S- Situation
S- Situation
B- Background
Yes , I stated it clearly and right away: Add 0 minSomewhat, I mentioned the issue but missed details: Add +1 min No, I jumped straight into data without context: Add +2 min
S- Situation
Did you clearly open your report with the patient’s name, location, and reason for the call?
Did you clearly open your report with the patient’s name, location, and reason for the call?
Did you summarize the key information — vitals, history, recent changes, or meds?
Title
Did you clearly open your report with the patient’s name, location, and reason for the call?
Title
Use this side to give more information about a topic.
Use this side to give more information about a topic.
Each card focuses on one part of the SBAR framework — Situation, Background, Assessment, and Recommendation.
Subtitle
Subtitle
For every part that was unclear or incomplete, imagine Dr. Lee needing to pause and ask questions before taking action. Each of those moments adds time to your total response — and in a cardiac emergency, every minute matters.
Rate yourself on each card to see how much time your report might have added to the patient’s overall care.
🟢 Yes — I stated it clearly and right away. (add 0 min)🟡 Somewhat — I mentioned the issue but missed details. (add +1 min) 🔴 No — I jumped straight into data without context. (add +2 min)
🟢 Yes — I stated it clearly and right away. (add 0 min)🟡 Somewhat — I mentioned the issue but missed details. (add +1 min) 🔴 No — I jumped straight into data without context. (add +2 min)
Yes — I gave my impression or concern. (add 0 min) Somewhat — I hinted at it but wasn’t direct. (add +1 min) No — I didn’t include my assessment. (add +2 min)
Yes — I stated what I needed. (add 0 min) Somewhat — I implied it but didn’t ask outright. (add +1 min) No — I didn’t make a clear request. (add +2 min)
S- Situation
S- Situation
R - Recommendation
A - Assessment
Did you clearly open your report with the patient’s name, location, and reason for the call?
Did you clearly open your report with the patient’s name, location, and reason for the call?
Did you share your clinical impression or concern, like “possible MI” or “ST elevation noted”?
Did you ask for a specific order, test, or next step from Dr. Lee?
Title
Title
Use this side to give more information about a topic.
Use this side to give more information about a topic.
Subtitle
Subtitle
Next
Time elapsed since arrival: 27 minutes
Review your SBAR report to Dr. Lee by flipping through the following cards.
🟢 Yes — I stated it clearly and right away. (add 0 min)🟡 Somewhat — I mentioned the issue but missed details. (add +1 min) 🔴 No — I jumped straight into data without context. (add +2 min)
🟢 Yes — I stated it clearly and right away. (add 0 min)🟡 Somewhat — I mentioned the issue but missed details. (add +1 min) 🔴 No — I jumped straight into data without context. (add +2 min)
Yes — I shared all key details. (add 0 min)Somewhat — I mentioned a few but not all. (add +1 min) No — I left out important background. (add +2 min)
S- Situation
S- Situation
B- Background
Yes , I stated it clearly and right away: Add 0 minSomewhat, I mentioned the issue but missed details: Add +1 min No, I jumped straight into data without context: Add +2 min
S- Situation
View SBAR Report
Did you clearly open your report with the patient’s name, location, and reason for the call?
Did you clearly open your report with the patient’s name, location, and reason for the call?
Did you summarize the key information — vitals, history, recent changes, or meds?
Title
Did you clearly open your report with the patient’s name, location, and reason for the call?
Title
Use this side to give more information about a topic.
Use this side to give more information about a topic.
Subtitle
Subtitle
Each card focuses on one part of the SBAR framework — Situation, Background, Assessment, and Recommendation.
For every part that was unclear or incomplete, imagine Dr. Lee needing to pause and ask questions before taking action. Each of those moments adds time to your total response — and in a cardiac emergency, every minute matters.
Rate yourself on each card to see how much time your report might have added to the patient’s overall care.
🟢 Yes — I stated it clearly and right away. (add 0 min)🟡 Somewhat — I mentioned the issue but missed details. (add +1 min) 🔴 No — I jumped straight into data without context. (add +2 min)
🟢 Yes — I stated it clearly and right away. (add 0 min)🟡 Somewhat — I mentioned the issue but missed details. (add +1 min) 🔴 No — I jumped straight into data without context. (add +2 min)
Yes — I gave my impression or concern. (add 0 min) Somewhat — I hinted at it but wasn’t direct. (add +1 min) No — I didn’t include my assessment. (add +2 min)
Yes — I stated what I needed. (add 0 min) Somewhat — I implied it but didn’t ask outright. (add +1 min) No — I didn’t make a clear request. (add +2 min)
S- Situation
S- Situation
R - Recommendation
A - Assessment
Did you clearly open your report with the patient’s name, location, and reason for the call?
Did you clearly open your report with the patient’s name, location, and reason for the call?
Did you share your clinical impression or concern, like “possible MI” or “ST elevation noted”?
Did you ask for a specific order, test, or next step from Dr. Lee?
Title
Title
Use this side to give more information about a topic.
Use this side to give more information about a topic.
Subtitle
Subtitle
Add these four cards' minutes to your total elapsed time
Next
Time elapsed since arrival: 32 minutes
Review your SBAR report to Dr. Lee by flipping through the following cards.
🟢 Yes — I stated it clearly and right away. (add 0 min)🟡 Somewhat — I mentioned the issue but missed details. (add +1 min) 🔴 No — I jumped straight into data without context. (add +2 min)
🟢 Yes — I stated it clearly and right away. (add 0 min)🟡 Somewhat — I mentioned the issue but missed details. (add +1 min) 🔴 No — I jumped straight into data without context. (add +2 min)
Yes — I shared all key details. (add 0 min)Somewhat — I mentioned a few but not all. (add +1 min) No — I left out important background. (add +2 min)
S- Situation
S- Situation
B- Background
Yes , I stated it clearly and right away: Add 0 minSomewhat, I mentioned the issue but missed details: Add +1 min No, I jumped straight into data without context: Add +2 min
S- Situation
View SBAR Report
Did you clearly open your report with the patient’s name, location, and reason for the call?
Did you clearly open your report with the patient’s name, location, and reason for the call?
Did you summarize the key information — vitals, history, recent changes, or meds?
Title
Did you clearly open your report with the patient’s name, location, and reason for the call?
Title
Use this side to give more information about a topic.
Use this side to give more information about a topic.
Subtitle
Subtitle
Each card focuses on one part of the SBAR framework — Situation, Background, Assessment, and Recommendation.
For every part that was unclear or incomplete, imagine Dr. Lee needing to pause and ask questions before taking action. Each of those moments adds time to your total response — and in a cardiac emergency, every minute matters.
Rate yourself on each card to see how much time your report might have added to the patient’s overall care.
🟢 Yes — I stated it clearly and right away. (add 0 min)🟡 Somewhat — I mentioned the issue but missed details. (add +1 min) 🔴 No — I jumped straight into data without context. (add +2 min)
🟢 Yes — I stated it clearly and right away. (add 0 min)🟡 Somewhat — I mentioned the issue but missed details. (add +1 min) 🔴 No — I jumped straight into data without context. (add +2 min)
Yes — I gave my impression or concern. (add 0 min) Somewhat — I hinted at it but wasn’t direct. (add +1 min) No — I didn’t include my assessment. (add +2 min)
Yes — I stated what I needed. (add 0 min) Somewhat — I implied it but didn’t ask outright. (add +1 min) No — I didn’t make a clear request. (add +2 min)
S- Situation
S- Situation
R - Recommendation
A - Assessment
Did you clearly open your report with the patient’s name, location, and reason for the call?
Did you clearly open your report with the patient’s name, location, and reason for the call?
Did you share your clinical impression or concern, like “possible MI” or “ST elevation noted”?
Did you ask for a specific order, test, or next step from Dr. Lee?
Title
Title
Use this side to give more information about a topic.
Use this side to give more information about a topic.
Subtitle
Subtitle
Add these four cards' minutes to your total elapsed time
Next
Time elapsed since arrival: 39 minutes
Review your SBAR report to Dr. Lee by flipping through the following cards.
🟢 Yes — I stated it clearly and right away. (add 0 min)🟡 Somewhat — I mentioned the issue but missed details. (add +1 min) 🔴 No — I jumped straight into data without context. (add +2 min)
🟢 Yes — I stated it clearly and right away. (add 0 min)🟡 Somewhat — I mentioned the issue but missed details. (add +1 min) 🔴 No — I jumped straight into data without context. (add +2 min)
Yes — I shared all key details. (add 0 min)Somewhat — I mentioned a few but not all. (add +1 min) No — I left out important background. (add +2 min)
S- Situation
S- Situation
B- Background
Yes , I stated it clearly and right away: Add 0 minSomewhat, I mentioned the issue but missed details: Add +1 min No, I jumped straight into data without context: Add +2 min
S- Situation
View SBAR Report
Did you clearly open your report with the patient’s name, location, and reason for the call?
Did you clearly open your report with the patient’s name, location, and reason for the call?
Did you summarize the key information — vitals, history, recent changes, or meds?
Title
Did you clearly open your report with the patient’s name, location, and reason for the call?
Title
Use this side to give more information about a topic.
Use this side to give more information about a topic.
Subtitle
Subtitle
Each card focuses on one part of the SBAR framework — Situation, Background, Assessment, and Recommendation.
For every part that was unclear or incomplete, imagine Dr. Lee needing to pause and ask questions before taking action. Each of those moments adds time to your total response — and in a cardiac emergency, every minute matters.
Rate yourself on each card to see how much time your report might have added to the patient’s overall care.
🟢 Yes — I stated it clearly and right away. (add 0 min)🟡 Somewhat — I mentioned the issue but missed details. (add +1 min) 🔴 No — I jumped straight into data without context. (add +2 min)
🟢 Yes — I stated it clearly and right away. (add 0 min)🟡 Somewhat — I mentioned the issue but missed details. (add +1 min) 🔴 No — I jumped straight into data without context. (add +2 min)
Yes — I gave my impression or concern. (add 0 min) Somewhat — I hinted at it but wasn’t direct. (add +1 min) No — I didn’t include my assessment. (add +2 min)
Yes — I stated what I needed. (add 0 min) Somewhat — I implied it but didn’t ask outright. (add +1 min) No — I didn’t make a clear request. (add +2 min)
S- Situation
S- Situation
R - Recommendation
A - Assessment
Did you clearly open your report with the patient’s name, location, and reason for the call?
Did you clearly open your report with the patient’s name, location, and reason for the call?
Did you share your clinical impression or concern, like “possible MI” or “ST elevation noted”?
Did you ask for a specific order, test, or next step from Dr. Lee?
Title
Title
Use this side to give more information about a topic.
Use this side to give more information about a topic.
Subtitle
Subtitle
Add these four cards' minutes to your total elapsed time
Next
Whats your total elapsed time after adding all four cards? This total represents the time from the patient’s arrival in the ED to the moment Dr. Lee received a clear handoff. In STEMI care, every minute of delay increases the risk of heart muscle damage. Choose your total below to see how your timing impacted the patient’s outcome.
≤ 30 minutes
31-34 minutes
35-38 minutes
39-47 minutes
30 minutes or less - Rapid Response
Nicely done! Because your assessments, interventions, and communication were all timely, the cath lab is activated right away. Medications are administered promptly, and John Miller is transferred within the recommended window. The team achieves reperfusion well before significant muscle damage occurs. You recognized the signs early, acted decisively, and communicated clearly. Each step — from noticing the ECG changes to escalating care and reporting — kept treatment moving without delay. ⏱ Every minute counted, and you used them effectively.
You spend several minutes obtaining Mr. Miller’s medication and cardiac history.
His pain rises to 9/10, and his heart rate increases as you gather details. You now prepare for a 12-lead ECG, recalling that the AHA/ACC Chest Pain Guideline (2021) recommends obtaining it within 10 minutes of arrival to identify ischemic changes early.
Elapsed Time: 20 minutes since arrival
Status: HR 100 | BP 150/92 | Skin pale | RR 24
Start ECG
Reflect & Submit
31-34 minutes- Minor Delay
You escalated the situation slightly past the ideal window. The cath lab team prepares, but John’s blood pressure dips, and he experiences shortness of breath before transfer. Nitroglycerin and fluids are administered to stabilize him en route. John reaches the cath lab just past the 20-minute mark. John recovers with mild ischemic changes that should heal over time. He’ll need short-term cardiac rehab but is expected to regain full function. A few small pauses in recognition, coordination, or escalation extended the timeline just enough for early tissue stress. ⏱ Even short delays can make a measurable difference.
You spend several minutes obtaining Mr. Miller’s medication and cardiac history.
His pain rises to 9/10, and his heart rate increases as you gather details. You now prepare for a 12-lead ECG, recalling that the AHA/ACC Chest Pain Guideline (2021) recommends obtaining it within 10 minutes of arrival to identify ischemic changes early.
Elapsed Time: 20 minutes since arrival
Status: HR 100 | BP 150/92 | Skin pale | RR 24
Start ECG
Reflect & Submit
You spend several minutes obtaining Mr. Miller’s medication and cardiac history.
His pain rises to 9/10, and his heart rate increases as you gather details. You now prepare for a 12-lead ECG, recalling that the AHA/ACC Chest Pain Guideline (2021) recommends obtaining it within 10 minutes of arrival to identify ischemic changes early.
Elapsed Time: 20 minutes since arrival
Status: HR 100 | BP 150/92 | Skin pale | RR 24
39-42 minutes- Moderate Delay
You escalated the situation slightly past the ideal window. By the time PCI begins, John’s blood pressure has dropped and he requires additional support. Blood flow is restored, but echocardiogram reveals moderate cardiac injury. John survives and begins a longer recovery with partial loss of heart function. Several short delays—each understandable on its own—added up across recognition, intervention, and communication. ⏱ Every minute of hesitation affects perfusion.
Reflect & Submit
Start ECG
You spend several minutes obtaining Mr. Miller’s medication and cardiac history.
His pain rises to 9/10, and his heart rate increases as you gather details. You now prepare for a 12-lead ECG, recalling that the AHA/ACC Chest Pain Guideline (2021) recommends obtaining it within 10 minutes of arrival to identify ischemic changes early.
Elapsed Time: 20 minutes since arrival
Status: HR 100 | BP 150/92 | Skin pale | RR 24
41-47 minutes- Critical Delay.
After notifying Dr. Lee, Cath lab activation is significantly delayed as the team works to confirm details and prepare resources. John develops ventricular tachycardia while waiting. He is resuscitated and transferred under critical conditions. PCI restores blood flow, but extensive muscle damage leads to long-term heart failure risk. The combined effect of delayed recognition, slower escalation, and logistical holdups prolonged ischemia. ⏱ In cardiac care, time is muscle—every minute matters.
Reflect & Submit
Start ECG
Critical Delay- Call another nurse to verify ECG
You flag a nearby nurse for a second look. While waiting, Mr. Miller winces, “It’s worse now… my arm hurts.”
The other nurse agrees it’s abnormal — but Dr. Lee still hasn’t been notified.
+4 minutes added, Total Elapsed time now 29 minutes
Every 10-minute delay in activation increases infarct size and long-term cardiac damage. You need to notify Dr. Lee immediately!
Click on the clipboard icon to review the STEMI protocol.
Notify the provider
ECG Results
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Unsafe Delay in Care
Waiting to repeat the ECG could miss the 10‑minute recognition window. John's conidtion remains untreated as you verify. +5 minutes added
Next
ECG Results
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ECG Results
ECG Results
Supportive Action but not priority
You administer 2 L/min oxygen via nasal cannula. His O₂ saturation improves from 96% to 98%, but his pain worsens, radiating to the left arm. The monitor shows an irregular rhythm, and Mr. Miller’s heart rate increases to 110 bpm.
+3 minutes added, Total elapsed time now 38 minutes
Oxygen therapy is supportive but does not restore perfusion. Escalation must come first. Every 10-minute delay in activation increases infarct size and long-term cardiac damage.
Click on the clipboard icon to review the STEMI protocol.
Notify the provider
ECG Results
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Supportive Action but not priority
You administer 2 L/min oxygen via nasal cannula. His O₂ saturation improves from 96% to 98%, but his pain worsens, radiating to the left arm. The monitor shows an irregular rhythm, and Mr. Miller’s heart rate increases to 110 bpm.
3 minutes added, elapsed time now 23 minutes
Oxygen therapy is supportive but does not restore perfusion. Escalation must come first. Every 10-minute delay in activation increases infarct size and long-term cardiac damage.
Click on the clipboard icon to review the STEMI protocol.
Notify the provieer
Unsafe Delay in Care
Waiting to repeat the ECG could miss the 10‑minute recognition window. John's conidtion remains untreated as you verify. +5 minutes added
Next
Incomplete Interpretation
The pattern across leads II, III, and aVF shows clear ST elevation — a key sign of heart muscle injury.
ECG Results
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua.Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore.
Excellent Critical Recognition
ST-segment elevation in leads II, III, and aVF confirms an inferior wall STEMI, most often due to right coronary artery (RCA) occlusion. You’ve identified a time-sensitive emergency — immediate activation of the STEMI/chest-pain protocol is required within 10 minutes of presentation (AHA/ACC Chest Pain Guideline, 2021).
Continue
ECG Results
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua.Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore.
Incomplete Interpretation
The pattern across leads II, III, and aVF shows clear ST elevation — a key sign of heart muscle injury.
Incorrect Lead Correlation
The changes you observed don’t align with the lead groups for anterior or lateral walls. Leads V1–V6 reflect anterior and lateral views — but the ST elevation here appears only in II, III, and aVF, which face the inferior wall of the heart. Misidentifying the location could delay activation of the correct cath-lab team.
Incorrect Lead Correlation
Incorrect area. These leads view the inferior wall, not the lateral one.
ECG Results
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ECG Results
Strong Clinical Judgment
According to AHA/ACC guidelines (2021), provider notification should occur within 10 minutes of identifying ST elevation. Door-to-balloon target: ≤ 90 minutes from arrival.
T0 minutes added, Elapsed time now 22 minutes
Click on the clipboard icon to review the STEMI protocol.
Notify the provider
Reassess and Document
You stop to reassess; Pain 8/10, BP 160/96, diaphoresis increasing. Mr. Miller grips the stretcher. His voice strains, "It's worse now." Seconds skip by as you type his vitals.
+2 minutes added, Total elapsed timed now27 minutes
Pain reassessment is appropriate but not the priority action when ECG shows a clear STEMI pattern. Every 10-minute delay in activation increases infarct size and long-term cardiac damage.
Click on the clipboard icon to review the STEMI protocol.
Notify the provider
Critical Delay- Call another nurse to verify ECG
You flag a nearby nurse for a second look. While waiting, Mr. Miller winces, “It’s worse now… my arm hurts.”
The other nurse agrees it’s abnormal — but Dr. Lee still hasn’t been notified.
+4 added, Total elapsed time now 39 minutes
You missed the ideal reperfusion window (goal ≤ 90 min door-to-balloon).
Every 10-minute delay in activation increases infarct size and long-term cardiac damage. You need to notify Dr. Lee immediately!
Click on the clipboard icon to review the STEMI protocol.
Notify the provider
Incomplete Interpretation
The pattern across leads II, III, and aVF shows clear ST elevation — a key sign of heart muscle injury.
ECG Results
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Strong Clinical Judgment
According to AHA/ACC guidelines (2021), provider notification should occur within 10 minutes of identifying ST elevation. Door-to-balloon target: ≤ 90 minutes from arrival.
0 min added, Elapsed time 20 minutes -- Excellent response window
Click on the clipboard icon to review the STEMI protocol.
Notify the provider
Critical Delay- Call another nurse to verify ECG
You flag a nearby nurse for a second look. While waiting, Mr. Miller winces, “It’s worse now… my arm hurts.”
The other nurse agrees it’s abnormal — but Dr. Lee still hasn’t been notified.
+4 added, Time elapsed now 26 minutes
You missed the ideal reperfusion window (goal ≤ 90 min door-to-balloon).
Every 10-minute delay in activation increases infarct size and long-term cardiac damage. You need to notify Dr. Lee immediately!
Click on the clipboard icon to review the STEMI protocol.
Notify the provider
Strong Clinical Judgment
According to AHA/ACC guidelines (2021), provider notification should occur within 10 minutes of identifying ST elevation. Door-to-balloon target: ≤ 90 minutes from arrival.
0 minutes added, Total Elapsed time now 35 minutes
Click on the clipboard icon to review the STEMI protocol.
Notify the provider
Supportive Action but not priority
You administer 2 L/min oxygen via nasal cannula. His O₂ saturation improves from 96% to 98%, but his pain worsens, radiating to the left arm. The monitor shows an irregular rhythm, and Mr. Miller’s heart rate increases to 110 bpm.
+3 minutes added, Total Elapsed time now 28 minutes
Oxygen therapy is supportive but does not restore perfusion. Escalation must come first. Every 10-minute delay in activation increases infarct size and long-term cardiac damage.
Click on the clipboard icon to review the STEMI protocol.
Notify the provieer
Strong Clinical Judgment
According to AHA/ACC guidelines (2021), provider notification should occur within 10 minutes of identifying ST elevation. Door-to-balloon target: ≤ 90 minutes from arrival.
0 minutes added, Total Elapsed time 25 minutes
Click on the clipboard icon to review the STEMI protocol.
Notify the provider
Unsafe Delay in Care
Waiting to repeat the ECG could miss the 10‑minute recognition window. John's conidtion remains untreated as you verify. +5 minutes added
Next
Excellent Critical Recognition
ST-segment elevation in leads II, III, and aVF confirms an inferior wall STEMI, most often due to right coronary artery (RCA) occlusion. You’ve identified a time-sensitive emergency — immediate activation of the STEMI/chest-pain protocol is required within 10 minutes of presentation (AHA/ACC Chest Pain Guideline, 2021).
Continue
Reassess and Document
You stop to reassess; Pain 8/10, BP 160/96, diaphoresis increasing. Mr. Miller grips the stretcher. His voice strains, "It's worse now." Seconds skip by as you type his vitals.
+2 minutes added, Total Elapsed time now37 minutes
Pain reassessment is appropriate but not the priority action when ECG shows a clear STEMI pattern. Every 10-minute delay in activation increases infarct size and long-term cardiac damage.
Click on the clipboard icon to review the STEMI protocol.
Notify the provider
ECG Results
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua.Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore.
Reassess and Document
You stop to reassess; Pain 8/10, BP 160/96, diaphoresis increasing. Mr. Miller grips the stretcher. His voice strains, "It's worse now." Seconds skip by as you type his vitals.
+2 added, Elapsed time now 24 minutes
Pain reassessment is appropriate but not the priority action when ECG shows a clear STEMI pattern. Every 10-minute delay in activation increases infarct size and long-term cardiac damage.
Click on the clipboard icon to review the STEMI protocol.
Notify the provider
Unsafe Delay in Care
Waiting to repeat the ECG could miss the 10‑minute recognition window. John's conidtion remains untreated as you verify. +5 minutes added
Next
Incomplete Interpretation
The pattern across leads II, III, and aVF shows clear ST elevation — a key sign of heart muscle injury.
ECG Results
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Supportive Action but not priority
You administer 2 L/min oxygen via nasal cannula. His O₂ saturation improves from 96% to 98%, but his pain worsens, radiating to the left arm. The monitor shows an irregular rhythm, and Mr. Miller’s heart rate increases to 110 bpm.
+3 minutes added, Total elapsed time now 25 minutes
Oxygen therapy is supportive but does not restore perfusion. Escalation must come first. Every 10-minute delay in activation increases infarct size and long-term cardiac damage.
Click on the clipboard icon to review the STEMI protocol.
Notify the provider
Initial Assessment Notes
- Patient is alert and oriented, x4
- He appears anxious and uncomfortable
- His skin is slightly pale but not diaphoretic
As you begin your initial assessment, you note:
ECG Results
ECG Results
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ECG Results
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua.Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore.
Reassess and Document
You stop to reassess; Pain 8/10, BP 160/96, diaphoresis increasing. Mr. Miller grips the stretcher. His voice strains, "It's worse now." Seconds skip by as you type his vitals.
+2 minutes, Elapsed time now 22 minutes
Pain reassessment is appropriate but not the priority action when ECG shows a clear STEMI pattern. Every 10-minute delay in activation increases infarct size and long-term cardiac damage.
Click on the clipboard icon to review the STEMI protocol.
Notify the provider
Initial Assessment
Heart Rate: 92 beats per minute Blood Pressure: 148/90 mmHg Respiratory Rate: 22 breaths per minute Oxygen Saturation: 96% on room air Temperature: 37.1°C (98.8°F)
Critical Delay- Call another nurse to verify ECG
You flag a nearby nurse for a second look. While waiting, Mr. Miller winces, “It’s worse now… my arm hurts.”
The other nurse agrees it’s abnormal — but Dr. Lee still hasn’t been notified.
+4 min added, Elapsed time now 24 minutes
Every 10-minute delay in activation increases infarct size and long-term cardiac damage. You need to notify Dr. Lee immediately!
Click on the clipboard icon to review the STEMI protocol.
Notify the provider
Incorrect Lead Correlation
The changes you observed don’t align with the lead groups for anterior or lateral walls. Leads V1–V6 reflect anterior and lateral views — but the ST elevation here appears only in II, III, and aVF, which face the inferior wall of the heart. Misidentifying the location could delay activation of the correct cath-lab team.
Excellent Critical Recognition
Correct. These findings confirm an inferior wall STEMI (heart attack from a right coronary artery blockage). Immediate provider notification is required within 10 minutes (AHA/ACC 2021).
Continue
ECG Results
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Excellent Critical Recognition
Correct. These findings confirm an inferior wall STEMI (heart attack from a right coronary artery blockage). Immediate provider notification is required within 10 minutes (AHA/ACC 2021).
Continue
Incorrect Lead Correlation
:* Incorrect area. These leads view the inferior wall, not the lateral one.
Chest Pain Assessment
Eleanna Santos
Created on October 8, 2025
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Transcript
Chest Pain Assessment
Nursing Critical Thinking Branching Scenario
Start
Learning objectives
Learners will be able to:
Continue
You’re a registered nurse in the Emergency Department at Community General Hospital. It’s a busy Tuesday morning, and patients are steadily arriving. As the triage nurse, you’re the first to see each person who walks in.
Continue
John Miller, 58 years old, approaches the desk. He looks anxious and holds his chest with one hand. “It started about 45 minutes ago while I was bringing in groceries,” he says.
Continue
Your task is to:
- Complete a focused initial assessment
- Decide the next nursing steps
- Prioritize actions and communicate effectively
Remember: Every minute counts in possible cardiac emergencies.Begin Assessment
Let's take a look at his initial assessment and vital signs.
Next
Excellent Priority Choice
Ordering an ECG within 10 minutes of arrival follows best practice.
No delay (10 minutes since arrival)
Status: Stable (94 bpm, SpO₂ 96%)
Next
Not quite
Rreassurance alone won’t reveal heart instability.
+10 min (Total time: 20 minutes)
Status: HR 108 bpm | BP 156/94 | Skin clammy
Next
Helpful, but not the main priority
History is important, but it shouldn't delay the ECG. Your detour means John’s pain worsens and HR increases.
+5 min (Total: 15 min)
Status: HR 100 bpm | BP 150/92 | Skin pale
Next
Thorough, but not timely
You perform a thorough pain assessment — strong skill, but it takes time. When a heart attack is suspected, every minute counts. Getting the ECG quickly is more important than collecting extra pain details.
+2 min added - Elapsed time now 12 min
Status: Stable (94 bpm, SpO₂ 96%)
Next
You’ve completed Mr. Miller’s initial assessment and noted his vital signs and appearance. What’s your next best action?
Perform PQRST pain assessment
Initiate a 12-lead ECG
Obtain medication and cardiac history
Reassure patient and have him sit in a wheelchair while you notify the provider.
Elapsed Time: 10 minutes since arrival
You act immediately, preparing and attaching a 12-lead ECG.
Nice work! AHA/ACC Chest Pain Guidelines (2021) state that you should obtain a 12-lead ECG within 10 minutes of the patient's arrival. While the leads are placed, you continue a focused pain assessment to correlate findings.
Elapsed Time: 10 minutes since arrival
Status: HR 94 | BP 148/90 | SpO₂ 96% | Anxious but stable
View ECG Results
Elapsed Time: 12 minutes since arrival
You complete your focused PQRST assessment.
Mr. Miller describes 8/10 substernal pressure radiating to the left arm, starting about 45 minutes ago while walking to his car. You recognize these as red-flag features of cardiac pain and immediately prepare to obtain a 12-lead ECG.
Elapsed Time: 12 minutes since arrival
Status: HR 92, BP 148/90, SpO₂ 96%, Pale but alert
Begin ECG
Elapsed Time: 15 minutes since arrival
You spend several minutes obtaining Mr. Miller’s medication and cardiac history.
His pain rises to 9/10, and his heart rate increases as you gather details. You now prepare for a 12-lead ECG, recalling that the AHA/ACC Chest Pain Guideline (2021) recommends obtaining it within 10 minutes of arrival to identify ischemic changes early.
Elapsed Time: 15 minutes since arrival
Status: HR 100 | BP 150/92 | Skin pale | RR 24
Start ECG
Elapsed Time: 20 minutes since arrival
Critical Delay.
While you reassure Mr. Miller, his pain intensifies to 10/10.He clutches his chest, breathing rapidly and diaphoretic. You recall that the American Heart Association and Emergency Nurses Association emphasize obtaining a 12-lead ECG within 10 minutes of presentation for any patient with possible cardiac chest pain (AHA/ACC 2021 Chest Pain Guideline; ENA Triage Standards). Delays beyond this window increase the risk of missed STEMI recognition and poorer outcomes.
Elapsed Time: 20 minutes since arrival
Status: HR 108 | BP 156/94 | Skin clammy | RR 26
You spend several minutes obtaining Mr. Miller’s medication and cardiac history.
His pain rises to 9/10, and his heart rate increases as you gather details. You now prepare for a 12-lead ECG, recalling that the AHA/ACC Chest Pain Guideline (2021) recommends obtaining it within 10 minutes of arrival to identify ischemic changes early.
Elapsed Time: 20 minutes since arrival
Status: HR 100 | BP 150/92 | Skin pale | RR 24
Start ECG
Start ECG
20 minutes
Time elapsed since arrival:
Click on the ECG strip to review the findings. Based on these results, what do these changes indicate?
Nonspecific ST-T changes
Inferior STEMI (leads II, II, aVF)
Lateral wall ischemia
Artifact - Repeat ECG later
22 minutes
Time elapsed since arrival:
Click on the ECG strip to review the findings. Based on these results, what do these changes most likely indicate?
Nonspecific ST-T changes
Inferior STEMI (leads II, II, aVF)
Lateral wall ischemia
Artifact - Repeat ECG later
25 minutes
Time elapsed since arrival:
Click on the ECG strip to review the findings. Based on these results, what do these changes most likely indicate?
Nonspecific ST-T changes
Inferior STEMI (leads II, II, aVF)
Lateral wall ischemia
Artifact - Repeat ECG later
30 minutes
Time elapsed since arrival:
Click on the ECG strip to review the findings. Based on these results, what do these changes most likely indicate?
Nonspecific ST-T changes
Inferior STEMI (leads II, II, aVF)
Lateral wall ischemia
Artifact - Repeat ECG later
20 minutes
Time elapsed since arrival:
After confirming the ECG shows ST elevation in leads II, III, and aVF, what is your priority nursing action?
Begin documenting the ECG findings and reassess vital signs.
Contact the on-call provider to report the ECG findings immediately.
Place the patient on 2 L/min oxygen and obtain a pain reassessment.
Call for another nurse to verify the ECG before escalating.
22 minutes
Time elapsed since arrival:
After confirming the ECG shows ST elevation in leads II, III, and aVF, what is your priority nursing action?
Begin documenting the ECG findings and reassess vital signs.
Contact the on-call provider to report the ECG findings immediately.
Place the patient on 2 L/min oxygen and obtain a pain reassessment.
Call for another nurse to verify the ECG before escalating.
25 minutes
Time elapsed since arrival:
After confirming the ECG shows ST elevation in leads II, III, and aVF, what is your priority nursing action?
Begin documenting the ECG findings and reassess vital signs.
Contact the on-call provider to report the ECG findings immediately.
Place the patient on 2 L/min oxygen and obtain a pain reassessment.
Call for another nurse to verify the ECG before escalating.
35 minutes
Time elapsed since arrival:
After confirming the ECG shows ST elevation in leads II, III, and aVF, what is your priority nursing action?
Begin documenting the ECG findings and reassess vital signs.
Contact the on-call provider to report the ECG findings immediately.
Place the patient on 2 L/min oxygen and obtain a pain reassessment.
Call for another nurse to verify the ECG before escalating.
Time elapsed since arrival:
23 minutes
You prepare to call Dr. Lee about Mr. Miller's condition. Write your report in the Padlet below using the SBAR framework to report clearly and quickly. Your communication can change the outcome.
Next
You prepare to call Dr. Lee about Mr. Miller's condition. Write your report in the Padlet below using the SBAR framework to report clearly and quickly. Your communication can change the outcome.
Time elapsed since arrival:
27 minutes
Next
Time elapsed since arrival:
32 minutes
You prepare to call Dr. Lee about Mr. Miller's condition. Write your report in the Padlet below using the SBAR framework to report clearly and quickly. Your communication can change the outcome.
Next
Time elapsed since arrival:
39 minutes
You prepare to call Dr. Lee about Mr. Miller's condition. Write your report in the Padlet below using the SBAR framework to report clearly and quickly. Your communication can change the outcome.
Next
Time elapsed since arrival:
23 minutes
Now it's time to rate your SBAR Report
In a real clinical situation, every second counts. When communication isn’t clear, time is lost — the provider may have to ask follow-up questions, confirm details, or clarify your concern before acting. In this reflection, you’ll review your SBAR report to Dr. Lee and rate how clearly you communicated each part of the SBAR framework: Situation, Background, Assessment, and Recommendation. For every section that was vague, incomplete, or unclear, extra minutes will be added to your total elapsed time — representing the delay in patient care that results when the message isn’t concise or complete. By the end, you’ll add up your total time to see how your communication affected the patient’s outcome.
Next
Time elapsed since arrival:
27 minutes
Now it's time to rate your SBAR Report
In a real clinical situation, every second counts. When communication isn’t clear, time is lost — the provider may have to ask follow-up questions, confirm details, or clarify your concern before acting. In this reflection, you’ll review your SBAR report to Dr. Lee and rate how clearly you communicated each part of the SBAR framework: Situation, Background, Assessment, and Recommendation. For every section that was vague, incomplete, or unclear, extra minutes will be added to your total elapsed time — representing the delay in patient care that results when the message isn’t concise or complete. By the end, you’ll add up your total time to see how your communication affected the patient’s outcome.
Next
Time elapsed since arrival:
32 minutes
Now it's time to rate your SBAR Report
In a real clinical situation, every second counts. When communication isn’t clear, time is lost — the provider may have to ask follow-up questions, confirm details, or clarify your concern before acting. In this reflection, you’ll review your SBAR report to Dr. Lee and rate how clearly you communicated each part of the SBAR framework: Situation, Background, Assessment, and Recommendation. For every section that was vague, incomplete, or unclear, extra minutes will be added to your total elapsed time — representing the delay in patient care that results when the message isn’t concise or complete. By the end, you’ll add up your total time to see how your communication affected the patient’s outcome.
Next
Time elapsed since arrival:
38 minutes
Now it's time to rate your SBAR Report
In a real clinical situation, every second counts. When communication isn’t clear, time is lost — the provider may have to ask follow-up questions, confirm details, or clarify your concern before acting. In this reflection, you’ll review your SBAR report to Dr. Lee and rate how clearly you communicated each part of the SBAR framework: Situation, Background, Assessment, and Recommendation. For every section that was vague, incomplete, or unclear, extra minutes will be added to your total elapsed time — representing the delay in patient care that results when the message isn’t concise or complete. By the end, you’ll add up your total time to see how your communication affected the patient’s outcome.
Next
Time elapsed since arrival: 23 minutes
Review your SBAR report to Dr. Lee by flipping through the following cards.
Add the minutes from each card to your total elapsed time
View SBAR Report
🟢 Yes — I stated it clearly and right away. (add 0 min)🟡 Somewhat — I mentioned the issue but missed details. (add +1 min) 🔴 No — I jumped straight into data without context. (add +2 min)
🟢 Yes — I stated it clearly and right away. (add 0 min)🟡 Somewhat — I mentioned the issue but missed details. (add +1 min) 🔴 No — I jumped straight into data without context. (add +2 min)
Yes — I shared all key details. (add 0 min)Somewhat — I mentioned a few but not all. (add +1 min) No — I left out important background. (add +2 min)
S- Situation
S- Situation
B- Background
Yes , I stated it clearly and right away: Add 0 minSomewhat, I mentioned the issue but missed details: Add +1 min No, I jumped straight into data without context: Add +2 min
S- Situation
Did you clearly open your report with the patient’s name, location, and reason for the call?
Did you clearly open your report with the patient’s name, location, and reason for the call?
Did you summarize the key information — vitals, history, recent changes, or meds?
Title
Did you clearly open your report with the patient’s name, location, and reason for the call?
Title
Use this side to give more information about a topic.
Use this side to give more information about a topic.
Each card focuses on one part of the SBAR framework — Situation, Background, Assessment, and Recommendation.
Subtitle
Subtitle
For every part that was unclear or incomplete, imagine Dr. Lee needing to pause and ask questions before taking action. Each of those moments adds time to your total response — and in a cardiac emergency, every minute matters. Rate yourself on each card to see how much time your report might have added to the patient’s overall care.
🟢 Yes — I stated it clearly and right away. (add 0 min)🟡 Somewhat — I mentioned the issue but missed details. (add +1 min) 🔴 No — I jumped straight into data without context. (add +2 min)
🟢 Yes — I stated it clearly and right away. (add 0 min)🟡 Somewhat — I mentioned the issue but missed details. (add +1 min) 🔴 No — I jumped straight into data without context. (add +2 min)
Yes — I gave my impression or concern. (add 0 min) Somewhat — I hinted at it but wasn’t direct. (add +1 min) No — I didn’t include my assessment. (add +2 min)
Yes — I stated what I needed. (add 0 min) Somewhat — I implied it but didn’t ask outright. (add +1 min) No — I didn’t make a clear request. (add +2 min)
S- Situation
S- Situation
R - Recommendation
A - Assessment
Did you clearly open your report with the patient’s name, location, and reason for the call?
Did you clearly open your report with the patient’s name, location, and reason for the call?
Did you share your clinical impression or concern, like “possible MI” or “ST elevation noted”?
Did you ask for a specific order, test, or next step from Dr. Lee?
Title
Title
Use this side to give more information about a topic.
Use this side to give more information about a topic.
Subtitle
Subtitle
Next
Time elapsed since arrival: 27 minutes
Review your SBAR report to Dr. Lee by flipping through the following cards.
🟢 Yes — I stated it clearly and right away. (add 0 min)🟡 Somewhat — I mentioned the issue but missed details. (add +1 min) 🔴 No — I jumped straight into data without context. (add +2 min)
🟢 Yes — I stated it clearly and right away. (add 0 min)🟡 Somewhat — I mentioned the issue but missed details. (add +1 min) 🔴 No — I jumped straight into data without context. (add +2 min)
Yes — I shared all key details. (add 0 min)Somewhat — I mentioned a few but not all. (add +1 min) No — I left out important background. (add +2 min)
S- Situation
S- Situation
B- Background
Yes , I stated it clearly and right away: Add 0 minSomewhat, I mentioned the issue but missed details: Add +1 min No, I jumped straight into data without context: Add +2 min
S- Situation
View SBAR Report
Did you clearly open your report with the patient’s name, location, and reason for the call?
Did you clearly open your report with the patient’s name, location, and reason for the call?
Did you summarize the key information — vitals, history, recent changes, or meds?
Title
Did you clearly open your report with the patient’s name, location, and reason for the call?
Title
Use this side to give more information about a topic.
Use this side to give more information about a topic.
Subtitle
Subtitle
Each card focuses on one part of the SBAR framework — Situation, Background, Assessment, and Recommendation.
For every part that was unclear or incomplete, imagine Dr. Lee needing to pause and ask questions before taking action. Each of those moments adds time to your total response — and in a cardiac emergency, every minute matters. Rate yourself on each card to see how much time your report might have added to the patient’s overall care.
🟢 Yes — I stated it clearly and right away. (add 0 min)🟡 Somewhat — I mentioned the issue but missed details. (add +1 min) 🔴 No — I jumped straight into data without context. (add +2 min)
🟢 Yes — I stated it clearly and right away. (add 0 min)🟡 Somewhat — I mentioned the issue but missed details. (add +1 min) 🔴 No — I jumped straight into data without context. (add +2 min)
Yes — I gave my impression or concern. (add 0 min) Somewhat — I hinted at it but wasn’t direct. (add +1 min) No — I didn’t include my assessment. (add +2 min)
Yes — I stated what I needed. (add 0 min) Somewhat — I implied it but didn’t ask outright. (add +1 min) No — I didn’t make a clear request. (add +2 min)
S- Situation
S- Situation
R - Recommendation
A - Assessment
Did you clearly open your report with the patient’s name, location, and reason for the call?
Did you clearly open your report with the patient’s name, location, and reason for the call?
Did you share your clinical impression or concern, like “possible MI” or “ST elevation noted”?
Did you ask for a specific order, test, or next step from Dr. Lee?
Title
Title
Use this side to give more information about a topic.
Use this side to give more information about a topic.
Subtitle
Subtitle
Add these four cards' minutes to your total elapsed time
Next
Time elapsed since arrival: 32 minutes
Review your SBAR report to Dr. Lee by flipping through the following cards.
🟢 Yes — I stated it clearly and right away. (add 0 min)🟡 Somewhat — I mentioned the issue but missed details. (add +1 min) 🔴 No — I jumped straight into data without context. (add +2 min)
🟢 Yes — I stated it clearly and right away. (add 0 min)🟡 Somewhat — I mentioned the issue but missed details. (add +1 min) 🔴 No — I jumped straight into data without context. (add +2 min)
Yes — I shared all key details. (add 0 min)Somewhat — I mentioned a few but not all. (add +1 min) No — I left out important background. (add +2 min)
S- Situation
S- Situation
B- Background
Yes , I stated it clearly and right away: Add 0 minSomewhat, I mentioned the issue but missed details: Add +1 min No, I jumped straight into data without context: Add +2 min
S- Situation
View SBAR Report
Did you clearly open your report with the patient’s name, location, and reason for the call?
Did you clearly open your report with the patient’s name, location, and reason for the call?
Did you summarize the key information — vitals, history, recent changes, or meds?
Title
Did you clearly open your report with the patient’s name, location, and reason for the call?
Title
Use this side to give more information about a topic.
Use this side to give more information about a topic.
Subtitle
Subtitle
Each card focuses on one part of the SBAR framework — Situation, Background, Assessment, and Recommendation.
For every part that was unclear or incomplete, imagine Dr. Lee needing to pause and ask questions before taking action. Each of those moments adds time to your total response — and in a cardiac emergency, every minute matters. Rate yourself on each card to see how much time your report might have added to the patient’s overall care.
🟢 Yes — I stated it clearly and right away. (add 0 min)🟡 Somewhat — I mentioned the issue but missed details. (add +1 min) 🔴 No — I jumped straight into data without context. (add +2 min)
🟢 Yes — I stated it clearly and right away. (add 0 min)🟡 Somewhat — I mentioned the issue but missed details. (add +1 min) 🔴 No — I jumped straight into data without context. (add +2 min)
Yes — I gave my impression or concern. (add 0 min) Somewhat — I hinted at it but wasn’t direct. (add +1 min) No — I didn’t include my assessment. (add +2 min)
Yes — I stated what I needed. (add 0 min) Somewhat — I implied it but didn’t ask outright. (add +1 min) No — I didn’t make a clear request. (add +2 min)
S- Situation
S- Situation
R - Recommendation
A - Assessment
Did you clearly open your report with the patient’s name, location, and reason for the call?
Did you clearly open your report with the patient’s name, location, and reason for the call?
Did you share your clinical impression or concern, like “possible MI” or “ST elevation noted”?
Did you ask for a specific order, test, or next step from Dr. Lee?
Title
Title
Use this side to give more information about a topic.
Use this side to give more information about a topic.
Subtitle
Subtitle
Add these four cards' minutes to your total elapsed time
Next
Time elapsed since arrival: 39 minutes
Review your SBAR report to Dr. Lee by flipping through the following cards.
🟢 Yes — I stated it clearly and right away. (add 0 min)🟡 Somewhat — I mentioned the issue but missed details. (add +1 min) 🔴 No — I jumped straight into data without context. (add +2 min)
🟢 Yes — I stated it clearly and right away. (add 0 min)🟡 Somewhat — I mentioned the issue but missed details. (add +1 min) 🔴 No — I jumped straight into data without context. (add +2 min)
Yes — I shared all key details. (add 0 min)Somewhat — I mentioned a few but not all. (add +1 min) No — I left out important background. (add +2 min)
S- Situation
S- Situation
B- Background
Yes , I stated it clearly and right away: Add 0 minSomewhat, I mentioned the issue but missed details: Add +1 min No, I jumped straight into data without context: Add +2 min
S- Situation
View SBAR Report
Did you clearly open your report with the patient’s name, location, and reason for the call?
Did you clearly open your report with the patient’s name, location, and reason for the call?
Did you summarize the key information — vitals, history, recent changes, or meds?
Title
Did you clearly open your report with the patient’s name, location, and reason for the call?
Title
Use this side to give more information about a topic.
Use this side to give more information about a topic.
Subtitle
Subtitle
Each card focuses on one part of the SBAR framework — Situation, Background, Assessment, and Recommendation.
For every part that was unclear or incomplete, imagine Dr. Lee needing to pause and ask questions before taking action. Each of those moments adds time to your total response — and in a cardiac emergency, every minute matters. Rate yourself on each card to see how much time your report might have added to the patient’s overall care.
🟢 Yes — I stated it clearly and right away. (add 0 min)🟡 Somewhat — I mentioned the issue but missed details. (add +1 min) 🔴 No — I jumped straight into data without context. (add +2 min)
🟢 Yes — I stated it clearly and right away. (add 0 min)🟡 Somewhat — I mentioned the issue but missed details. (add +1 min) 🔴 No — I jumped straight into data without context. (add +2 min)
Yes — I gave my impression or concern. (add 0 min) Somewhat — I hinted at it but wasn’t direct. (add +1 min) No — I didn’t include my assessment. (add +2 min)
Yes — I stated what I needed. (add 0 min) Somewhat — I implied it but didn’t ask outright. (add +1 min) No — I didn’t make a clear request. (add +2 min)
S- Situation
S- Situation
R - Recommendation
A - Assessment
Did you clearly open your report with the patient’s name, location, and reason for the call?
Did you clearly open your report with the patient’s name, location, and reason for the call?
Did you share your clinical impression or concern, like “possible MI” or “ST elevation noted”?
Did you ask for a specific order, test, or next step from Dr. Lee?
Title
Title
Use this side to give more information about a topic.
Use this side to give more information about a topic.
Subtitle
Subtitle
Add these four cards' minutes to your total elapsed time
Next
Whats your total elapsed time after adding all four cards? This total represents the time from the patient’s arrival in the ED to the moment Dr. Lee received a clear handoff. In STEMI care, every minute of delay increases the risk of heart muscle damage. Choose your total below to see how your timing impacted the patient’s outcome.
≤ 30 minutes
31-34 minutes
35-38 minutes
39-47 minutes
30 minutes or less - Rapid Response
Nicely done! Because your assessments, interventions, and communication were all timely, the cath lab is activated right away. Medications are administered promptly, and John Miller is transferred within the recommended window. The team achieves reperfusion well before significant muscle damage occurs. You recognized the signs early, acted decisively, and communicated clearly. Each step — from noticing the ECG changes to escalating care and reporting — kept treatment moving without delay. ⏱ Every minute counted, and you used them effectively.
You spend several minutes obtaining Mr. Miller’s medication and cardiac history.
His pain rises to 9/10, and his heart rate increases as you gather details. You now prepare for a 12-lead ECG, recalling that the AHA/ACC Chest Pain Guideline (2021) recommends obtaining it within 10 minutes of arrival to identify ischemic changes early.
Elapsed Time: 20 minutes since arrival
Status: HR 100 | BP 150/92 | Skin pale | RR 24
Start ECG
Reflect & Submit
31-34 minutes- Minor Delay
You escalated the situation slightly past the ideal window. The cath lab team prepares, but John’s blood pressure dips, and he experiences shortness of breath before transfer. Nitroglycerin and fluids are administered to stabilize him en route. John reaches the cath lab just past the 20-minute mark. John recovers with mild ischemic changes that should heal over time. He’ll need short-term cardiac rehab but is expected to regain full function. A few small pauses in recognition, coordination, or escalation extended the timeline just enough for early tissue stress. ⏱ Even short delays can make a measurable difference.
You spend several minutes obtaining Mr. Miller’s medication and cardiac history.
His pain rises to 9/10, and his heart rate increases as you gather details. You now prepare for a 12-lead ECG, recalling that the AHA/ACC Chest Pain Guideline (2021) recommends obtaining it within 10 minutes of arrival to identify ischemic changes early.
Elapsed Time: 20 minutes since arrival
Status: HR 100 | BP 150/92 | Skin pale | RR 24
Start ECG
Reflect & Submit
You spend several minutes obtaining Mr. Miller’s medication and cardiac history.
His pain rises to 9/10, and his heart rate increases as you gather details. You now prepare for a 12-lead ECG, recalling that the AHA/ACC Chest Pain Guideline (2021) recommends obtaining it within 10 minutes of arrival to identify ischemic changes early.
Elapsed Time: 20 minutes since arrival
Status: HR 100 | BP 150/92 | Skin pale | RR 24
39-42 minutes- Moderate Delay
You escalated the situation slightly past the ideal window. By the time PCI begins, John’s blood pressure has dropped and he requires additional support. Blood flow is restored, but echocardiogram reveals moderate cardiac injury. John survives and begins a longer recovery with partial loss of heart function. Several short delays—each understandable on its own—added up across recognition, intervention, and communication. ⏱ Every minute of hesitation affects perfusion.
Reflect & Submit
Start ECG
You spend several minutes obtaining Mr. Miller’s medication and cardiac history.
His pain rises to 9/10, and his heart rate increases as you gather details. You now prepare for a 12-lead ECG, recalling that the AHA/ACC Chest Pain Guideline (2021) recommends obtaining it within 10 minutes of arrival to identify ischemic changes early.
Elapsed Time: 20 minutes since arrival
Status: HR 100 | BP 150/92 | Skin pale | RR 24
41-47 minutes- Critical Delay.
After notifying Dr. Lee, Cath lab activation is significantly delayed as the team works to confirm details and prepare resources. John develops ventricular tachycardia while waiting. He is resuscitated and transferred under critical conditions. PCI restores blood flow, but extensive muscle damage leads to long-term heart failure risk. The combined effect of delayed recognition, slower escalation, and logistical holdups prolonged ischemia. ⏱ In cardiac care, time is muscle—every minute matters.
Reflect & Submit
Start ECG
Critical Delay- Call another nurse to verify ECG
You flag a nearby nurse for a second look. While waiting, Mr. Miller winces, “It’s worse now… my arm hurts.”
The other nurse agrees it’s abnormal — but Dr. Lee still hasn’t been notified.
+4 minutes added, Total Elapsed time now 29 minutes
Every 10-minute delay in activation increases infarct size and long-term cardiac damage. You need to notify Dr. Lee immediately!
Click on the clipboard icon to review the STEMI protocol.
Notify the provider
ECG Results
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Unsafe Delay in Care
Waiting to repeat the ECG could miss the 10‑minute recognition window. John's conidtion remains untreated as you verify. +5 minutes added
Next
ECG Results
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ECG Results
ECG Results
Supportive Action but not priority
You administer 2 L/min oxygen via nasal cannula. His O₂ saturation improves from 96% to 98%, but his pain worsens, radiating to the left arm. The monitor shows an irregular rhythm, and Mr. Miller’s heart rate increases to 110 bpm.
+3 minutes added, Total elapsed time now 38 minutes
Oxygen therapy is supportive but does not restore perfusion. Escalation must come first. Every 10-minute delay in activation increases infarct size and long-term cardiac damage.
Click on the clipboard icon to review the STEMI protocol.
Notify the provider
ECG Results
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Supportive Action but not priority
You administer 2 L/min oxygen via nasal cannula. His O₂ saturation improves from 96% to 98%, but his pain worsens, radiating to the left arm. The monitor shows an irregular rhythm, and Mr. Miller’s heart rate increases to 110 bpm.
3 minutes added, elapsed time now 23 minutes
Oxygen therapy is supportive but does not restore perfusion. Escalation must come first. Every 10-minute delay in activation increases infarct size and long-term cardiac damage.
Click on the clipboard icon to review the STEMI protocol.
Notify the provieer
Unsafe Delay in Care
Waiting to repeat the ECG could miss the 10‑minute recognition window. John's conidtion remains untreated as you verify. +5 minutes added
Next
Incomplete Interpretation
The pattern across leads II, III, and aVF shows clear ST elevation — a key sign of heart muscle injury.
ECG Results
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Excellent Critical Recognition
ST-segment elevation in leads II, III, and aVF confirms an inferior wall STEMI, most often due to right coronary artery (RCA) occlusion. You’ve identified a time-sensitive emergency — immediate activation of the STEMI/chest-pain protocol is required within 10 minutes of presentation (AHA/ACC Chest Pain Guideline, 2021).
Continue
ECG Results
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Incomplete Interpretation
The pattern across leads II, III, and aVF shows clear ST elevation — a key sign of heart muscle injury.
Incorrect Lead Correlation
The changes you observed don’t align with the lead groups for anterior or lateral walls. Leads V1–V6 reflect anterior and lateral views — but the ST elevation here appears only in II, III, and aVF, which face the inferior wall of the heart. Misidentifying the location could delay activation of the correct cath-lab team.
Incorrect Lead Correlation
Incorrect area. These leads view the inferior wall, not the lateral one.
ECG Results
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ECG Results
Strong Clinical Judgment
According to AHA/ACC guidelines (2021), provider notification should occur within 10 minutes of identifying ST elevation. Door-to-balloon target: ≤ 90 minutes from arrival.
T0 minutes added, Elapsed time now 22 minutes
Click on the clipboard icon to review the STEMI protocol.
Notify the provider
Reassess and Document
You stop to reassess; Pain 8/10, BP 160/96, diaphoresis increasing. Mr. Miller grips the stretcher. His voice strains, "It's worse now." Seconds skip by as you type his vitals.
+2 minutes added, Total elapsed timed now27 minutes
Pain reassessment is appropriate but not the priority action when ECG shows a clear STEMI pattern. Every 10-minute delay in activation increases infarct size and long-term cardiac damage.
Click on the clipboard icon to review the STEMI protocol.
Notify the provider
Critical Delay- Call another nurse to verify ECG
You flag a nearby nurse for a second look. While waiting, Mr. Miller winces, “It’s worse now… my arm hurts.”
The other nurse agrees it’s abnormal — but Dr. Lee still hasn’t been notified.
+4 added, Total elapsed time now 39 minutes
You missed the ideal reperfusion window (goal ≤ 90 min door-to-balloon).
Every 10-minute delay in activation increases infarct size and long-term cardiac damage. You need to notify Dr. Lee immediately!
Click on the clipboard icon to review the STEMI protocol.
Notify the provider
Incomplete Interpretation
The pattern across leads II, III, and aVF shows clear ST elevation — a key sign of heart muscle injury.
ECG Results
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Strong Clinical Judgment
According to AHA/ACC guidelines (2021), provider notification should occur within 10 minutes of identifying ST elevation. Door-to-balloon target: ≤ 90 minutes from arrival.
0 min added, Elapsed time 20 minutes -- Excellent response window
Click on the clipboard icon to review the STEMI protocol.
Notify the provider
Critical Delay- Call another nurse to verify ECG
You flag a nearby nurse for a second look. While waiting, Mr. Miller winces, “It’s worse now… my arm hurts.”
The other nurse agrees it’s abnormal — but Dr. Lee still hasn’t been notified.
+4 added, Time elapsed now 26 minutes
You missed the ideal reperfusion window (goal ≤ 90 min door-to-balloon).
Every 10-minute delay in activation increases infarct size and long-term cardiac damage. You need to notify Dr. Lee immediately!
Click on the clipboard icon to review the STEMI protocol.
Notify the provider
Strong Clinical Judgment
According to AHA/ACC guidelines (2021), provider notification should occur within 10 minutes of identifying ST elevation. Door-to-balloon target: ≤ 90 minutes from arrival.
0 minutes added, Total Elapsed time now 35 minutes
Click on the clipboard icon to review the STEMI protocol.
Notify the provider
Supportive Action but not priority
You administer 2 L/min oxygen via nasal cannula. His O₂ saturation improves from 96% to 98%, but his pain worsens, radiating to the left arm. The monitor shows an irregular rhythm, and Mr. Miller’s heart rate increases to 110 bpm.
+3 minutes added, Total Elapsed time now 28 minutes
Oxygen therapy is supportive but does not restore perfusion. Escalation must come first. Every 10-minute delay in activation increases infarct size and long-term cardiac damage.
Click on the clipboard icon to review the STEMI protocol.
Notify the provieer
Strong Clinical Judgment
According to AHA/ACC guidelines (2021), provider notification should occur within 10 minutes of identifying ST elevation. Door-to-balloon target: ≤ 90 minutes from arrival.
0 minutes added, Total Elapsed time 25 minutes
Click on the clipboard icon to review the STEMI protocol.
Notify the provider
Unsafe Delay in Care
Waiting to repeat the ECG could miss the 10‑minute recognition window. John's conidtion remains untreated as you verify. +5 minutes added
Next
Excellent Critical Recognition
ST-segment elevation in leads II, III, and aVF confirms an inferior wall STEMI, most often due to right coronary artery (RCA) occlusion. You’ve identified a time-sensitive emergency — immediate activation of the STEMI/chest-pain protocol is required within 10 minutes of presentation (AHA/ACC Chest Pain Guideline, 2021).
Continue
Reassess and Document
You stop to reassess; Pain 8/10, BP 160/96, diaphoresis increasing. Mr. Miller grips the stretcher. His voice strains, "It's worse now." Seconds skip by as you type his vitals.
+2 minutes added, Total Elapsed time now37 minutes
Pain reassessment is appropriate but not the priority action when ECG shows a clear STEMI pattern. Every 10-minute delay in activation increases infarct size and long-term cardiac damage.
Click on the clipboard icon to review the STEMI protocol.
Notify the provider
ECG Results
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua.Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore.
Reassess and Document
You stop to reassess; Pain 8/10, BP 160/96, diaphoresis increasing. Mr. Miller grips the stretcher. His voice strains, "It's worse now." Seconds skip by as you type his vitals.
+2 added, Elapsed time now 24 minutes
Pain reassessment is appropriate but not the priority action when ECG shows a clear STEMI pattern. Every 10-minute delay in activation increases infarct size and long-term cardiac damage.
Click on the clipboard icon to review the STEMI protocol.
Notify the provider
Unsafe Delay in Care
Waiting to repeat the ECG could miss the 10‑minute recognition window. John's conidtion remains untreated as you verify. +5 minutes added
Next
Incomplete Interpretation
The pattern across leads II, III, and aVF shows clear ST elevation — a key sign of heart muscle injury.
ECG Results
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua.Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore.
Supportive Action but not priority
You administer 2 L/min oxygen via nasal cannula. His O₂ saturation improves from 96% to 98%, but his pain worsens, radiating to the left arm. The monitor shows an irregular rhythm, and Mr. Miller’s heart rate increases to 110 bpm.
+3 minutes added, Total elapsed time now 25 minutes
Oxygen therapy is supportive but does not restore perfusion. Escalation must come first. Every 10-minute delay in activation increases infarct size and long-term cardiac damage.
Click on the clipboard icon to review the STEMI protocol.
Notify the provider
Initial Assessment Notes
As you begin your initial assessment, you note:
ECG Results
ECG Results
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ECG Results
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua.Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore.
Reassess and Document
You stop to reassess; Pain 8/10, BP 160/96, diaphoresis increasing. Mr. Miller grips the stretcher. His voice strains, "It's worse now." Seconds skip by as you type his vitals.
+2 minutes, Elapsed time now 22 minutes
Pain reassessment is appropriate but not the priority action when ECG shows a clear STEMI pattern. Every 10-minute delay in activation increases infarct size and long-term cardiac damage.
Click on the clipboard icon to review the STEMI protocol.
Notify the provider
Initial Assessment
Heart Rate: 92 beats per minute Blood Pressure: 148/90 mmHg Respiratory Rate: 22 breaths per minute Oxygen Saturation: 96% on room air Temperature: 37.1°C (98.8°F)
Critical Delay- Call another nurse to verify ECG
You flag a nearby nurse for a second look. While waiting, Mr. Miller winces, “It’s worse now… my arm hurts.”
The other nurse agrees it’s abnormal — but Dr. Lee still hasn’t been notified.
+4 min added, Elapsed time now 24 minutes
Every 10-minute delay in activation increases infarct size and long-term cardiac damage. You need to notify Dr. Lee immediately!
Click on the clipboard icon to review the STEMI protocol.
Notify the provider
Incorrect Lead Correlation
The changes you observed don’t align with the lead groups for anterior or lateral walls. Leads V1–V6 reflect anterior and lateral views — but the ST elevation here appears only in II, III, and aVF, which face the inferior wall of the heart. Misidentifying the location could delay activation of the correct cath-lab team.
Excellent Critical Recognition
Correct. These findings confirm an inferior wall STEMI (heart attack from a right coronary artery blockage). Immediate provider notification is required within 10 minutes (AHA/ACC 2021).
Continue
ECG Results
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua.Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore.
Excellent Critical Recognition
Correct. These findings confirm an inferior wall STEMI (heart attack from a right coronary artery blockage). Immediate provider notification is required within 10 minutes (AHA/ACC 2021).
Continue
Incorrect Lead Correlation
:* Incorrect area. These leads view the inferior wall, not the lateral one.