Paramedic diagnosis of acute coronary syndrome in the out-of-hospital patient with acute, non-traumatic chest pain

This article describes why most of the current methods taught to paramedics to identify ACS patients contradicts evidence that has been reported in the literature over the past 20 years.  Areas where current teaching contradicts the evidence are highlighted, traditionally taught assessments which are non-diagnostic are identified, and those that are most diagnostic are listed and explained using  a novel, evidence-based method to assess the patient’s history; the acronym RSVP 3 (Radiation, Similarity, Variation, Pleuritic, Positional, Palpation) This acronym is meant to replace other commonly used, but non-diagnostically sensitive, acronyms such as OPQRST, DOLOR, SOCRATES and CHEST PAIN.  Evidence to support this recommendations is given.