Hi everyone,I work at a small rural hospital (in the ED) that does no heart caths, but we do admit a good many "atypical" CP pt's to rule them out. Administration wants all of these to be admitted with the AMI core measure form, which some of our admitting doctors refuse to do-- as they do not consider the pt to be having an acute MI. Just curious to what others in this situation are doing...Thanks,CIndy
KimRN41514 37 Posts Oct 25, 2008 We put the patients in and use our ACS protocol. If you would like, I could share it with you.
mmutk, BSN, RN, EMT-I 482 Posts Specializes in Emergency Dept, ICU. Has 11 years experience. Oct 28, 2008 Patients with ACS or Atypical chest pain in my opinion should be included in the core measures of the american heart association's treatment of chest pain (AMI or not)
blueheaven 832 Posts Oct 28, 2008 We use the ACS protocol on all of them because you never know. It's our policy. Sounds like administration needs to have a sit down with your docs on why this is necessary.
KNARE 19 Posts Specializes in ED. Has 28 years experience. Oct 31, 2008 Our chest pain protocol follows the AMI Core Measures and includes all the usual lab work, PCXR, ASA, 1st EKG with in 10 min. upon arrival and a repeat EKG in 1 hour. If a definative "Clinical Impression" has not been made, we have a Clinical Decision Unit in our ED. These pts. receive 2 additional sets of cardiac myeomarkers and an EKG that are done at 4hrs. and 8hrs. from the initial EKG. The ED Physicians manage these pts. and a Cardiology consult is required on all these pts. The Cardiologist will sometimes order a stress test prior to discharge if appropriate. The CDU works great for us. This did help to increase the teamwork between the Cardiologists and ED PhysiciansHope this helps,Renee
