The prospective audit identified 157 possible ACS cases (30 STEMI). 105 patients (5 STEMI) were admitted through the Triage service operational on a weekday, 9 to 5 basis. Nurse led Triage brought about improvements in the time to initial assessment with 104 patients (99%) seen within 10 min of arrival, time to initial ECG (101/105 (96%) within 10 min vs. 76/157 (48%), p < 0.001*). The use of antiplatelet therapy and Heparin for high-risk patients also improved. 80% (28/35) received Clopidogrel compared to 45% (36/80) pre-triage (p < 0.001*) and 97% (34/35) received Heparin compared to 80% (36/80) pre-triage (p < 0.001*). An unexpected reduction in the use of Betablockers was noted (74% vs. 93% (p < 0.01*)). A non significant trend for high-risk patients to be either managed by or referred to a cardiologist during triage was noted (18/ 35 (52%) compared to 27/80 (34%) p = ns⁎).No differences in the prescription of Aspirin, Clopidogrel, Heparin or Betablocker for low risk patients were noted. * By chi square Conclusion: A CCU based, Nurse-led chest pain triage service may be an effective means of providing accurate and prompt assessment and improved clinical management of ACS patients presenting to District General Hospitals.
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