Chest Pain

There is, at the moment, a campaign by the British Heart Foundation, backed by the LAS, to make more people call an ambulance if they experience chest pain. So far so good. Sounds sensible, since chest pain is probably the most common indicator of a heart attack. It can, of course, be an indicator of many other ailments, so not every chest pain is a heart attack. So that's why you need to call in the professionals. Which is just what happened. We had a call from a care home to an elderly lady with chest pain, shortness of breath and vomiting. A common type of call, especially in the part of the world where I work. On arrival the patient really did have all three symptoms, as opposed to the call taking system just making them up. (I know that it's not always the call-takers fault, and that AMPDS has much to answer for). The bit that confused us was this. The care home decided to call the GP first, rather than call an ambulance. They should know better, but it gets worse. The GP heard all the symptoms, couldn't be bothered to come and assess the patient, so prescribed over the phone. The prescription? Glass of WARM MILK! Oh, and if she doesn't get better, call an ambulance. Warm milk?!?!? For chest pain that you haven't assessed? And vomiting on top of it? Sometimes I despair. If the professionals don't follow sound advice, what hope for the general public?
The outcome for this lady was good. She had a bad chest infection, and with some IV paracetamol and antibiotics was already much better when we went back to see how she was doing in A&E.