Diabetic Ketoacidosis

Chest pain is one of the most common reasons for presentation to the emergency department (ED), accounting for 2–6% of emergency department attendances and 20% of emergency admissions to hospital (Fothergill et al., 1993)According to the Vital Statistics Annual Report 2019 from the Central Statistics Office (CSO), there were a total of 8,989 deaths attributed to diseases of the circulatory system. Of these, 4,163 were due to ischaemic heart disease and 1,627 to cerebrovascular disease, (Vital Statistics Yearly Summary 2019 – CSO – Central Statistics Office, 2020).

In this case study the author will present a detailed bio-psychosocial profile of a critically ill patient who presented to the emergency department with chest pain. To maintain anonymity and confidentially, as outlined under Principle Four of the Code of Professional Conduct and Ethics, (NMBI- The Code- Principle 4: Trust & Confidentiality, 2020), the pseudonym Rose will be used.

Rose is a sixty-year-old female who attended the ED where the author works as a member of the multidisciplinary team (MDT) as a nurse. Rose presented to triage with the complaint of sudden onset of central chest pain radiating up to her left shoulder and down her left arm lasting approximately two hours. There was no history of trauma and Rose had no other associated symptoms. She has a past medical history of hypercholesterolemia, high body mass index (BMI), and hypertension. Rose was assessed and triaged using the Manchester Triage System which is the tool used in the hospital Rose attended. The Manchester Triage System is a valid instrument for the first assessment of emergency patients in critical condition upon arrival (Gräff et al., 2018).