Deakin University
Browse

File(s) under permanent embargo

It is safe to manage selected patients with acute coronary syndromes in unmonitored beds

Version 2 2024-06-04, 09:44
Version 1 2016-12-02, 08:03
journal contribution
posted on 2024-06-04, 09:44 authored by AM Kelly, Debra KerrDebra Kerr
This prospective, observational study evaluated the safety of the Western Hospital admission protocol for patients with suspected acute coronary syndromes. The study included all patients admitted from the Emergency Department with an admission diagnosis of unstable angina, post infarct angina, atypical chest pain, or chest pain for evaluation. Data collected included demographic data, admission diagnosis, location of admission (bed with or without cardiac monitoring), past medical history and presenting chest pain history to determine Agency for Health Care Policy (AHCPR) and Western Hospital (WH) protocol classifications, cardiac enzyme assays, electrocardiogram analysis, adverse outcomes [death, myocardial infarction (MI), dysrhythmia, acute pulmonary edema, recurrent pain], diagnosis at hospital discharge, and length of stay-(LOS). There were 508 patients with a mean age of 63.7 years enrolled in the study. Three hundred nineteen (62.8%) were admitted to beds without any cardiac monitoring. There was one unexpected death in the unmonitored group, an 85 year-old patient who suffered a presumed dysrhythmia and whom the treating physician had decided was not for resuscitation. Twelve patients suffered nonfatal MI, and none suffered pulmonary edema. All MI patients made an uneventful recovery, and none required thrombolysis. If all patients had been admitted to an area of care based on AHCPR guidelines, an additional 310 admissions to monitored beds would have been required. The results of this study suggest that selected patients with suspected acute coronary syndromes can be safely managed in beds without continuous cardiac monitoring.

History

Journal

Journal of ermergency medicine

Volume

21

Pagination

227-233

Location

Amsterdam, The Netherlands

ISSN

0736-4679

Language

eng

Publication classification

C1.1 Refereed article in a scholarly journal

Copyright notice

2001, Elsevier Science

Issue

3

Publisher

Elsevier