{
  "card_id": "CHEST-PAIN-ESCALATION-v1",
  "title": "Chest pain escalation",
  "applies_to": [
    "all ages",
    "field clinic",
    "disaster response"
  ],
  "required_observations": [
    "chest pain description",
    "onset and duration",
    "shortness of breath report",
    "sweating or fainting report",
    "radiation to arm, jaw, back, or shoulder",
    "available vital signs"
  ],
  "red_flags": [
    "chest pain or pressure",
    "chest pain with shortness of breath",
    "chest pain with sweating, fainting, or severe weakness",
    "pain radiating to arm, jaw, back, or shoulder",
    "chest pain with abnormal vital signs according to local protocol"
  ],
  "escalation_criteria": [
    "Chest pain with shortness of breath, fainting, sweating, severe weakness, radiation, or abnormal vital signs requires emergency escalation.",
    "Any unresolved chest pain requires urgent protocol review according to local protocol."
  ],
  "local_actions": [
    "Document onset, duration, pain description, associated symptoms, and vital signs for handoff.",
    "Keep the person under direct observation while escalation is arranged."
  ],
  "forbidden_actions": [
    "Do not diagnose the cause of chest pain.",
    "Do not provide medication, dosing, or procedure instructions unless a local clinician or protocol explicitly provides them."
  ],
  "safety_boundary": "Prototype protocol navigation card for trained-responder review only. It is not a clinical guideline and cannot diagnose, prescribe, dose, triage autonomously, or override local protocol.",
  "source_note": "Prototype protocol card derived from public guideline concepts. Not a clinical guideline."
}