Does Your ED have a Chest Pain Triage Nurse?

[Mary Ellen]

Our ED is restructuring. We currently have a 7 bed sub-dept called

Chest Pain Observation. This will move to be an extension of CCU to free up more ED beds. There is still a great need for chest pain triage and quick intervention and I want to proprose such a position to our director. I'm looking for information on this type of position. In other words, if the 'wheel' is already invented, I don't want to re-invent it. Thanks.

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Mary Ellen Perry

[CHUBBY]

Mary Ellen, I don't know the volume of the ER you're at. One ER I work at sees 40,000/year. A patient signs a book listing their chief complaint. Chest pains are triaged first. The triage room is big. It has a separate area with a stretcher and curtains so an EKG can be done in triage. It's then shown to the doc for anything acute which ups the ante on getting the person back into a room. I'm not sure having a separate triage nurse just to do chest pain would be cost effective

[Sarah, RNBScN]

No but this is how we deal with our chest pains.

Rapid triage.

12 & 15 lead ECG's notify MD

Hx: APQRST

ASA 80 mg. 2 p.o. ( if not contraindicated)

O2 @ via NP to keep sats > 92%

Cardiac monitor, VS are being monitored

Start 2 IV's 1) NS at KVO 2) NS lock

ICU labs, TNI.

Nitro. 0.3 mg SL (if not contraindicated)

Reassess

Portable CXR (depends on the MD)

Hope this helps.

[healingtouchRN]

yup, we have a chest pain center, once triaged they are placed there unless needing to acutely go to CV lab for revascularization. we can hold them there to check serial enzymes & await a bed. It has it's own nurse & the rooms have TV's & beds more comfy for a longer wait in the ED. Nice set up when not rockin & rollin'!