Cardiac patients in the ER - a poll

[NurseCherlove]

Quick question for you ER nurses:

Approximately what percentage of your patients come in for cardiac-related problems? And do you think this percentage is fairly reflective of all ERs in general or just yours for some reason?

Thanks for all input!

[goshin706]

i would have to say that our er % is about 40% cardiac, sob, cp etc.

[CritterLover, BSN, RN]

i would guess it at about 20-25% for perceived cardiac issues -- that is, the patient and/or triage thinks it might be cardiac related. only a small percentage of that turns out to be actual cardiac issues, and most of those are established cardiac patients having an exacerbation. most of our cardiac workups turn out negative.

we have quite a bit more abdominal pain than chest pain. in fact, much of our chest pain turns out to be reflux.

we also see a whole bunch of earaches/sore throats/colds/lacs/boils/rashes that some ers might not see as much of (is there still such a place where people actually see their family md??), that is going to cause the cardiac % to decrease.

[caliotter3]

This is not a direct answer to your question, but I thought you might find it interesting to hear that over the times that I've been to the ER for other complaints, except for once, I've experienced cardiac symptoms right there in the ER. The ER is a disturbing place it seems. Sometimes my cardiac complaints were at least assessed to some extent, once or twice I was brushed off or did not receive appropriate treatment. Just recently though I almost convinced myself to go to the ER for cardiac symptoms as my only complaint. Twice as a matter of fact. I talked myself out of it. That's why I'm looking for a cardiologist! I'm beginning to get the hints!

[loricatus]

I would say about 40% are suspected cardiac (based upon triage nurse initiating an EKG). Since epigastric pain with any cardiac risk factor will get the pt. an EKG, at least 10% (of the 40%) will turn out to be a GI issue. Also, PNA sxs in those over 55 will have r/o cardiac initiated.

This was about the same percentage as the last ED I worked at, so I would think this is the norm for the area-but, I have no way of really knowing the answer to this. I would think that the Level I & IIs will get a good share of the cardiac over community and level IIIs in the vicinity.

[rjflyn, ASN, RN]

Actual vs suspected. We work up a lot of people in our ER. Many of then young as well, significant cocaine and meth problem in the area. Anyway we probably admit 20-25% of the pt's we see on a daily basis. Of those i would imagine one out of 5 is a CP observation. Then again last I saw we average sending 0.9 a day to the cardiac cath lab. So to guess probably 15-20% are CP pt's at triage.

Rj

[JessicRN]

Are you asking what % of pt came in with a cardiac complaint or what % had a cardiac diagnosis in the end?

Our place about 75 % say they have a cardiac c/o because they were told "if you tell them you have chest pain, they won't make you wait". The true cardiac patient who gets admitted for the chest pain/CHF is more like 20%

[nC09n34t0]

We see 100 to 120 patients daily. About 10 to 20 percent c/o "Chest pain." Those arriving after say 2pm are usually placed in the CP Center for serial labs and EKGs and are stress tested the next AM. If they arrive prior to 2pm they usually have thier stress done that afternoon. Very few, I mean less than 1 percent turn out to have disease.

And I agree with JessicRN about the patient saying he has chest pain just to go straight back and be seen, then only to say that was last month, his gout in his foot is what bothers him today. I guess its universal.

[Altra, BSN, RN]

We see about 150 patients daily. Maybe 30% are cardiac complaints, at least 1/2 of those are admitted. This is in an area with a significant senior population, as well as being an urban area with prevalent cocaine/crack use.

[meandragonbrett]

I would venture to say that about 65% of our case load is CV/pulmonary in nature (including CHF, AAA, AMI, etc.).

[DiannaK]

we see about 60-80 pts per day ...

Our C/P complaints seem to wax and wane ....

when I worked last night, we had zero C/P on my shift (3p-1a). It seemed to be a dangerous night to be at the ball field, since we had 4 or 5 (unrelated) pt that were hit with softballs/baseballs in various places!!

To me, it seems like they come in spurts.