We have a triage process without the ability (as of today) to obtain a 12 lead with having the patient moved into an ER bay. On the patients that read the manual and know what they're supposed to do when having "The Big One" (SOB, diaphoresis, left-sided crushin pain), we hit the mark without a problem. The issue is the "soft" or evolving STEMIs.
We're a 8-bed ER with 6 urgent care/Fast track beds with around 14,000 ER/20,000 Fast Track visits.
I don't know how many triage RN's you have at one time, but if we were doing ECG's for everyone who came in with chest pain, you'd have 5 other chest pains waiting in the waiting room to be triaged
I'm a traveler, and have worked at many different ER's- getting an EKG withing 10 minutes of a patient presenting to the ER with chest pain is the "gold standard" nationwide. An RN doesn't have to do it, a tech, CNA, or MA can also do the EKG, and then show it to a doc. It takes about 2 minutes to do an EKG, and this can be done by someone other than the triage RN while the RN is doing the rest of the triage. If the EKG is normal, the patient can be sent back to the waiting room until a room is available......
On my unit we teach all member of staff including the NA to do ECG ,but not even all the Doctors can thoroughly interpret the ECG .
I think we really need boosting so I am in the process urging the RN,s to do at least an on line course I had also found an attractive site and inform a few doctors
Only the doctors ,the ward sister ,the charge nurse and myself completed the ACLS ,NOT EVEN THE SUPERVISOR certified.
I ask to be transfer to that unit from maternity and when i get their a few days a ago i realise apart from the supervisor and the other 2 charge person I am the most senior nurse and midwife,hence it is chalenging supervising the juniors ,triaging and assessing yet the doctors will call on me to do the maternity cases.
I am liking it very much and wish i was there before now.Hopeful I will spend at least 6 months then resign and migrate.
Specializes in Critical Care,Emergenct,and Dialysis.
We have just finished doing a performance improvement program at Memorial Hospital in Chattanooga, We devised a plan to have 2 nurses and a tech to run the whole (CODE STEMI) we have a right nurse and a left nurse in which we assigned duties to each one along with the duties for the er tech, we also made a STEMI box with everything we would need to run the code (except for Morphine ,which is kept in the pxysis) we have decreased our dorr to needle time by 75% if you or anyone else would like more info please feel free to contact me. Thanks:cheers:
ERRNTraveler, RN
672 Posts
I'm a traveler, and have worked at many different ER's- getting an EKG withing 10 minutes of a patient presenting to the ER with chest pain is the "gold standard" nationwide. An RN doesn't have to do it, a tech, CNA, or MA can also do the EKG, and then show it to a doc. It takes about 2 minutes to do an EKG, and this can be done by someone other than the triage RN while the RN is doing the rest of the triage. If the EKG is normal, the patient can be sent back to the waiting room until a room is available......