Does anyone have standing orders or a practice guidline for pts with chest pain at thier facility?
It seems to me that pts get faster care for chest pain if they out in the community than if they are already in the hosp. If 911 is called they get O2, S/L Nitro, aspirin and an EKG as soon as the EMTs arrive. In the hosp they have to wait until the MD calls back and the nurse gets orders.
Please let me know what the procedure is at your facility and what literature supports your practice.
May 29, '06
Quote from Indy
Hmm. I think the ACLS protocols support fast NTG, ASA, O2, etc. Wouldn't that be support enough?
ACLS is intended as a protocol for dealing w/ emergency, resusitation situations. To use those protocols outside of a 'code' would not be appropriate. They aren't designed to replace MD orders; they are there as 'emergency' protocols.
CP, by itself, is not a resusitation emergency. There is an algorithm for 'ischemic CP' but, outside of an emergency situation, that algorithm must be subject to MD approval. If you look at the CP algorithm, it is dealing w/ pre-hospital/ED care. It is not a 'standing order' for admitted pts.
That being said, most cardiac pts I see have standing admit orders that cover EKG and MONA (morphine, O2, ntg, asa) for CP
Last edit by ZASHAGALKA on May 29, '06