Chest Pain on the Morning Commute
At 07:50 you are driving a passenger from Beau Bassin to Port Louis on the M1 motorway. In the rear seat the passenger, a man in his 50s, says he has crushing chest pain, sweating and nausea. He asks you to take him to a private clinic in Floréal because 'they know my file', but that is farther than the nearest emergency department in Port Louis. Traffic is heavy and the hard shoulder is partly blocked by a broken-down lorry. You have a first-aid kit, a charged phone and a passenger who is breathing but frightened. He refuses an ambulance because he thinks it will cost more. What should you do?
1. What are your immediate priorities and what should you communicate to emergency services?
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Stop as soon as it is safe, preferably on the hard shoulder or a lay-by with hazard lights on. Call emergency services and give the road, direction, nearest landmark, patient’s age, conscious state, breathing, chest pain and sweating. Follow the dispatcher’s instructions. Keep the passenger sitting and calm; loosen tight clothing; do not give food or drink; monitor breathing and be ready to start CPR if he becomes unresponsive and not breathing normally. Do not leave him alone. If an ambulance is coming, wait unless there is immediate danger. The private clinic request is understandable but secondary: chest pain needs emergency assessment, and a clinic farther away may not be equipped. Follow emergency-service advice on destination.
2. How do you decide between the private clinic and the nearest emergency department?
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Choose the nearest appropriate emergency department or the destination advised by the dispatcher. A patient with crushing chest pain should not be diverted to a non-emergency clinic for convenience. If the ambulance is delayed and you must transport, drive smoothly and legally; do not speed or jump lights unless a police officer directs you. Ask the dispatcher to alert the hospital. Keep the passenger’s phone and documents with him, note times of onset, call and arrival, and hand over information to staff. After the incident, report to the operator and complete an incident form. The reasoning is that time to defibrillation and medical assessment matters, but unsafe driving could cause a second casualty.