Place patient on a cardiac monitor, establish intravascular access (IV) access, give 162 mg to 325 mg chewable aspirin, clopidogrel, or ticagrelor (unless bypass surgery is imminent), control pain and consider oxygen (O2) therapy. Common descriptors of somatic pain are sharp, stabbing, and poking.Ī complete discussion of the management of ACS is beyond the scope of this paper however initial steps should be performed in patients with a diagnosis of ACS. Somatic pain is also less likely to refer to other parts of the body. Somatic pain is more specific than visceral pain, and patients will usually be able to point to a specific spot. Diaphragmatic irritation may refer to the shoulders as well. Symptoms like nausea and vomiting may also be a sign of visceral pain. Ischemic heart pain, for example, may refer to the left or right shoulder, jaw or left arm. Visceral pain also refers to other locations as a result of the nerves coursing through somatic nerve fibers as they reach the spinal cord. Common descriptors of visceral pain are dull, deep, pressure and squeezing. When asking patients to point with one finger where they feel the pain, they will often move their hand around a larger area. Visceral pain usually presents with a vague distribution pattern meaning that the patient is unlikely to localize the pain to a specific spot. It sometimes is helpful to consider the different etiologies of pain.
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