Friday, 2300 hours:
A 24 year-old woman presents to your Emergency Department after a motor vehicle collision. She was the restrained driver of a car that collided head-on with another vehicle. She is complaining only of chest pain and appears uncomfortable and anxious. The monitor shows sinus tachycardia and you spot a sternal fracture on her chest x-ray. After IVF and Fentanyl, she remains slightly tachycardic and you wonder:
- Do I need to send a troponin?
- If the troponin is negative does this patient need to be admitted?
- What other testing should I consider in the Emergency Department?