EKGs in triage

EDValerieRN, ASN, RN · Aug 19, 2006

We do... we have our triage PCT take the pt back to a little room, do the EKG, and show it to a doc. The doc then lets us know if he wants the patient back ASAP, or if the pt can wait a bit. Of course if the pt is symptomatic, we get them back as soon as possible. We have an EKG machine in triage for this purpose. I work in a 35 (soon to be 60) bed level 1.

ern91 · Aug 19, 2006

we also do ekgs at triage. we have 3 bays with stretchers, etc. we also do the ekgs on anyone c/o cp. and i do mean anyone. even children and young adults with no h/o cardiac. we are an accredited cardiac facility and to meet the reqiurements, we get the ekg w/in 5 minutes of triage time, run it to the doc who then gives further orders. we start a cardiac workup from triage then place pt in a room if available. we aren't allowed to make clinical judgements regarding atypical cp, such as being reproduceable, increases on movement, inspiration etc. can be very frustrating sometimes, but can also discover a heart problem someone didn't know they had.

mmutk, BSN, RN, EMT-I · Aug 21, 2006

If the back's full we EKG in TRIAGE.

CritterLover, BSN, RN · Aug 21, 2006

do it all the time as a screening tool for who needs to come back first. (we also start cies). our triage room is enclosed (with doors, not curtains), so we usually keep a 12 lead in there, and do one on just about everyone who c/o chest pain. to run one or not is at the triage nurse's discretion. the ekg is then shown to one of the mds, who will initial it and tell us what they want done -- wait their turn, can stay in the wr but need a work-up started, bring back asap, or bring back now.

i, too, find it fairly frustrating at times that we do ekgs on soooo many people, many of whom end up having chest pain due to cough/bronchitis. however, just when you think you have a person too young to be having true cardiac chest pain, you will end up having the crack/meth abuser that is having cardiac issues. plus, when the 20 year olds with the bs chest pain start fussing in the wr that "i've been out here for four hours, and i'm having chest pain," you can calmly point out that you did, indeed, take their chest pain seriously, but that everything is looking ok for now, so please have a seat!

jayne109, RN · Aug 21, 2006

We have 3 triage rooms and so anyone with CP gets one if we are full in the back. People of high risk get back automatically but a 23 y/o with chest pain gets an EKG, a doc looks at it and then they get back to the WR if they are normal. We also order labs an stuff in triage if it is full in the back and we have the staff in the back. Does anyone else do this?

Diane Fox · Aug 21, 2006

Yes, we do EKG's in triage. They are done by a tech if available or a trained pt advocate or the triage nurse. They are then shown to the ED doc and he has to inital and place the time he saw it. This is also done with all EKG's completed in the department. It saves the "I was never notified" by the MC.

gmced · Aug 22, 2006

Thanks for the feedback! If you do them in triage, do you all have a bed available out there? Does any one do EKGs on pts sitting in chairs?

jayne109, RN · Aug 22, 2006

Thanks for the feedback! If you do them in triage, do you all have a bed available out there? Does any one do EKGs on pts sitting in chairs?

we do. WE have a bed in triage but it is reserved for unresponsive pts. It is kept in a different place. If we need it for an EKG, we can use it but mostly we just sit them in the chair and get decent results. If the MD doesn't like it, we can redo it.