Facilitator notes

Facilitator, please role-play this patient and allow the student/team to collect a focusd history. The key elements are reported here, provide generic information when there is no applicable answer below.
After the role-play, provide the History handout to the player.

James Nguyen, 17 years old, non-Aboriginal or Torres Strait Islander.

Opening line: “Why am I so short of breath? I am never going to make it to States if I’m this unfit!”

You were at school basketball practice this afternoon. You were running and trying to take the ball off another player when you suddenly felt chest pain and shortness of breath. You thought initially you had been hit by the other player.

You stopped for a while and tried to catch your breath but were unable to keep playing. After a while, your coach moved you off the court, but you still didn’t feel better, so they called an ambulance.

You are still short of breath now, and there is a sharp pain on your left side when you take a breath in. You feel better when at rest, and if you are made to move, for instance lying down or getting up from the bed, you become very short of breath.

The pain is a 6/10 on inspiration, and a much more manageable dull ache when not taking a breath in. If you try to take a deeper breath, it hurts so much you need to stop.

The pain started at the same time the shortness of breath did. It is sharp, like you are being stabbed all over your ribcage on the left, up to your shoulder..

The only thing you can think to do to improve the pain is stop breathing, and you don’t want to do that!

You have been otherwise well. Basketball practice has been particularly strenuous at the moment as you are getting ready for the State Championship. School is otherwise going well; you are a little bit stressed out about exams as you have been focussing on basketball more than study.

If asked: you have no palpitations/feeling like your heart is racing; you don’t have a cough, your legs are not swollen, you sleep regularly at night, on one pillow, and have had no issues with shortness of breath prior to today.

Past medical history

Usually well. Have never had to come into emergency before. You are fully immunised.

Your family is well. Your dad is quite tall, and he has been told he might have a connective tissue disease but has never had this investigated. Once, when he was younger, he had a collapsed lung.

Lifestyle and social history

You don’t take any recreational drugs nor supplements; you don’t drink or smoke. You have tried beer at a party but didn’t like it.