1346: Health behaviour of pregnant women with congenital heart disease

Abstract

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.