How does your ED treat chest pain?

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?

from a bedside standpoint

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
from a bedside standpoint
Just curious....How long have you been a NP?

4 years

Specializes in Emergency & Trauma/Adult ICU.

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.

Specializes in Emergency.

And they get benzos too.

Specializes in Emergency Nursing.

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

Specializes in Emergency.
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.

I wont tell what school I went graduated from as that would state where I am located. sorry

Specializes in ER, progressive care.

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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Specializes in Emergency.
I wont tell what school I went graduated from as that would state where I am located. sorry

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......

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.

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