| |
The pharmacist
directs him to go to the urgent care clinic, which is in the mall
and alerts the clinic electronically that Mr Jones is coming.
Jones allows the clinic nurse to access his regional electronic
chart and his primary care physician's charted notes through MAINsuite™.
|
Clinical Assessment
|
|
Complaint
|
Onset
|
Factors
|
|
Chest
pain
|
Today
12:00 in mall after eating with SOB and radiation down let
arm
|
Past
history angina, CAD, PVD and CVD
|
| |
|
No relief
with antacid
|
|
Physical
|
|
Vital
Signs
|
BP 100/70,
HR 110 thready
|
|
|
Chest
|
Bilateral
basal creps
|
|
|
CVS
|
Muflled
HS systolic murmur
|
|
|
Impression:
|
Acute
MI
|
Stat
ECG, Teleconference with Heart Institute, cardiologist on-call
|
|
Disposition
|
Transfer
to Heart Institute Angio room #2
|
|
CONTINUE
|
Clinic
Visits