Specialties Emergency Nursing Q/A
I am wondering how your ED treats chest pain. We get EKG in 15 mins, start IV give IV nitroglycerin, Zofran,Ativan, Dilaudid.5, Asa, and Plavix and chest X-ray and cardiac panel. What are your guys orders like?
dsherman
47 Posts
from a bedside standpoint
Esme12, ASN, BSN, RN
1 Article; 20,908 Posts
4 years
Altra, BSN, RN
6,255 Posts
But OP, you stated earlier in the thread that patients presenting to your ED with chest pain get narcotics almost immediately. Sounds like a drug seeket's dream.
emtb2rn, BSN, RN, EMT-B
2,942 Posts
And they get benzos too.
1fastRN
196 Posts
I'm an RN. I don't give any meds as an independent action. I order the EKG, CXR, throw in an IV, draw labs, and set them up on O2. If the patient is very distressed I'll let the doc know and often get a verbal order for meds. I've never given dilaudid for a CP, I don't think. Morphine is sometimes ordered if they're very distressed. It's usually just ASA and the full work up.
I agree it is a drug seekers dream
We let our docs call it because it literally activates the cath team. .[/quote'] Yep, same in my house. I'll still call 'em when it's obvious.
Yep, same in my house. I'll still call 'em when it's obvious.
I wont tell what school I went graduated from as that would state where I am located. sorry
turnforthenurse, MSN, NP
3,364 Posts
Door to EKG = 10minutes. Cardiac monitor, O2 @ 2L, line and labs (troponin, CBC, cmp, coags), 324mg ASA chewed and SL NTG x3, usually before morphine is ordered.
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zmansc, ASN, RN
867 Posts
Except you already stated you work in Ohio and Kentucky, did you not? lol
The protocols for chest pain are fairly standard and I can't imagine a NP with 4yr experience asking for them on this board.
Odd......
Anna Flaxis, BSN, RN
1 Article; 2,816 Posts
Nurse initiated protocols:
EKG within 10 minutes of triage.
18g. in the RAC.
CBC, CMP, Troponin, CK-MB
CXR
ASA 162mg. PO if no true allergy and no ASA already taken
O2 @ 2LPM NC
NTG and/or morphine only after MD eval, by MD order
If STEMI, heparin bolus, second PIV, ship to hospital with cath lab within 45 minutes of triage time. If not STEMI, MD consults with cardiologist and we either ship them or hold onto them for a bit longer to rule out MI.