Chest Pain Protocols in triage

[MidnightSun1]

Curious to know what other places do for Chest Pain protocols in triage. We've had an increase in wait times and are trying to find ways to modify ours. We do EKG, if ischemic the patient comes straight back, if non ischemic the patient stays in waiting room but gets labs drawn and waits his/her turn but doesn't get a repeat troponin until is in the treatment area, no matter the waiting time. If the initial troponin is elevated the patient comes straight back, but if it is not the patient stays in the waiting room for however many hours it takes to get a bed with no repeat in labs unless their condition deteriorates.

[EDRNCCmom, MSN, RN]

Your ED sounds just like the one I work in! We do the same thing - EKG - wait if non ischemic and lab work sent. We try to get chest pain patients back as soon as we can but sometimes they have to wait too if they are stable.

[DayDreamin ER CRNP]

Our goal is to priority triage the CP patient and get an EKG within 5 minutes. We don't always achieve that because everyone has figured out that if they say they are having CP, they get back quicker. We all know the routine.

We have a desk nurse that helps to prioritize the triage patients by asking some generalized questions w/out getting too involved at the desk.

In the triage room, we are asking PMH questions and if the pt has had an MI we assign him/her a higher acuity and those pts get back faster. Immediately if they are an acute MI / ischemic, we get them back immediately, of course. If not, the pt will get labs drawn and may get a chest X-ray ordered. If the pt is still waiting the lobby we do draw another set of enzymes in three hours.

We get an old EKG on all pts that have an EKG which can usually get within 2-3 minutes fi the patient has had one at one of our facilities.

[TheSquire, DNP, APRN, NP]

We have practice guidelines on top of the general chest pain protocol of EKG with read by the doc in