Following a brachial plexus block, a patient reports chest discomfort. What is the next order expected for this patient?

In the scenario following a brachial plexus block where a patient reports chest discomfort, the most appropriate next step is to obtain a 12 lead EKG. This choice is crucial because chest discomfort can be indicative of potential cardiovascular complications, including myocardial ischemia or other cardiac events. A 12 lead EKG allows healthcare providers to assess the electrical activity of the heart and identify any abnormalities in heart rhythm or signs of ischemia that may need immediate medical attention.

While obtaining a chest X-ray could provide information about possible lung or cardiac issues, it is less immediate and less specific for evaluating cardiac conditions compared to an EKG. Performing a chest ultrasound may be helpful in assessing certain cardiac conditions or abnormalities, but it is not typically the first-line diagnostic tool for chest discomfort. Administering analgesics might relieve pain, but it does not address the underlying cause of the discomfort and could mask symptoms that need further evaluation. Therefore, obtaining a 12 lead EKG is the most appropriate and time-sensitive action in this clinical context.