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Scenario: An Angina Worry


Please note: The users who submit scenarios have declared that all patient details are fiction. We cannot guarentee the accuracy of any suggested treatment or the realism of suggested observations. You should judge these for yourself.



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Scenario Overview:
The first aiders are at a large event and are covering the whole town. The event has finished and it's now the evening and getting towards the end of the cover. An older man walks up to the first aiders and asks if they carry a spray. After questioning, the man will tell them that he has Angina and currently has chest pain but left his GTN spray back in his hotel (around the corner). However, after finding out that the don't carry a spray, the man will refuse all treatment and say his is fine and will just go to the pub (next to where the first aiders are). This scenario is about dealing with the situation where a patient has capacity and refuses assessment and treatment.
Difficulty:
First Aider Moderate
How the scenario should progress:
Once the patient has established that the first aiders don't have a GTN spray then he will just say he is fine and want to go get a beer. If the first aiders suggest they could walk with him to go and get his spray, he will say it's fine, it's nearer to get to the pub.
Patient 1:
Name: Jim Corne    Age: 68    Sex: Male
Medication: GTN spray left in hotel round the corner
Allergies: None Known
Past medical/family/social history: Has Angina and is usually controlled well with the GTN spray.
Findings on examination: Patient able to walk and talk normally. The patient will not let a full examination or any obs to to be taken. From just looking at the patient, the patient doesn't appear in too much pain, is not short of breath and apart from stating that he has some chest pain, appears ok as far as can be seen.
Possible treatment from first aiders: The patients should try and persuade the patient to go with them to get his GTN spray and to allow him to be assessed. However, once they have assessed that he has capacity, they should go through their normal procedures for a patient refusing treatment. Advice to call 999 if doesn't change or gets worse.
Time after start: Refused



Tips for the patient actors:
Initially be looking for help but after realising you can't get the spray (which is what you were really after) because the pain isn't really bad, you will say you don't need treatment or assessment and that you just need a beer and the people in the pub will look after you.

Scenario submitted by: Scenario Library