Management of ACS for the BLS Provider

OPQRST-I
  • Onset of symptoms 
  • Provokes (provocation) “Does anything you do make this better or worse?” 
  • Quality of the pain. Have the patient use their own words rather than asking, “Do you have 9/10 substernal chest pain that radiates to your jaw and arm?” 
  • Radiating Pain.  Does the pain move anywhere else? 
  • Severity.  Usually rated on a 1 – 10 scale where 10 is the “worst” pain 
  • Time.  It is important to note the last known well time and exact point of symptom onset, as well as duration of pain. 
  • Interventions. Did any of the initial interventions performed aggravate or alleviate the pain?