Procedural Competency Assessment: by Gw625N

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									                                    PGY1 Chief Complaint Competency Assessment:
                                                    Chest Pain
    Goals and Objectives:
    To identify the emergent causes of chest pain (acute coronary syndrome, aortic dissection, pulmonary embolus, Boerhaave’s
    syndrome, tension pneumothorax, pericarditis with tamponade, pneumonia).
    To obtain a thorough history of a patient’s chief complaint of chest pain.
    To perform a thorough physical examination for the evaluation of chest pain.

    Date: _______________

    Resident: _____________________________________________________________

    Supervising Faculty: ____________________________________________________


 Reviews any available prehospital documentation and makes note of this in the chart
immediately notesinitialaddresses any abnormal vital signspatient, including a brief evaluation of airway, breathing, circulation;
       Performs an
                       and
                            assessment of the stability of the


quality, regionand documents severity, andhistory of presentonset (PQRST) of the chest pain
       Performs
                   and radiation,
                                   a thorough
                                                 timing/type of
                                                                 illness, accurately describing provoking/palliating factors, the


angina/myocardial infarction, pulmonary embolus,medical and dissectionhistory, focusing on risk factors for unstable
       Asks about and documents the patient’s past
                                                         and aortic
                                                                     surgical


(cutaneous andand documents a thorough physical examination, includingpulses, presence or absence of edema thorax
       Performs
                   musculoskeletal), cardiac exam, lung sounds, peripheral
                                                                                 a brief neurological examination, JVP,


the presenceand absence ofinterprets electrocardiography when indicated, identifying the rate, rhythm, and axis, intervals, and
       Orders
                or
                    correctly
                               ST-T wave abnormalities.

infiltrate, pleuralcorrectly interprets chest radiography whenthe mediastinum. the presence or absence of cardiomegaly,
       Orders and
                     effusion, pneumothorax, and widening of
                                                                  indicated, identifying


specifically considering life-threatening etiologiespainchest pain to data gathered through history and physical examination,
       Develops a differential diagnosis of the chest
                                                         of
                                                             appropriate



    Overall Competency (circle one)


    EXCELLENT                      SATISFACTORY                       UNSATISFACTORY


    Resident signature________________________________________________________

    Faculty Signature_________________________________________________________

								
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