Managing unstable angina and coronary care beds effectively

Abstract

This article is an evaluation of a new chest pain admission policy at

Validation of a tool to safely triage selected patients with chest pain to unmonitored beds

“…Our results were similar to previous studies of the CPP (Table 4). 13,17 In this study, patients with chest pain suspected to be of ischaemic origin who had a normal or unchanged initial ECG, no recurrent chest pain requiring IV GTN nor initial CK rise would have had no life‐threatening arrhythmias, no deaths nor cardiac arrest in the first 72 h of admission and few adverse events overall. The CPP triaged 60% fewer patients to an MNB than strict adherence to NHMRC recommendations.…”

“…This study thus externally validated the application of the CPP for ED disposition of chest pain patients. It adds to the weight of evidence in the literature questioning the role of CCM for all patients with chest pain 1–4,12 , 13,17 , 22,23 …”

“…developed a chest pain protocol (CPP) 12 that stratified patients with low‐risk criteria to an UMNB. The initial studies were small and retrospective 12,13 . A subsequent prospective study of 326 patients triaged to an UNMB, supported the safety and applicability of this protocol in practice 17 .…”

Acute coronary syndrome diagnosis at hospital discharge: How often do we get it right in the emergency department?

“…There are a few studies that have examined whether an ED ACS diagnosis is subsequently confirmed after admission to a hospital ward. Kelly et al 10 followed all patients who were diagnosed in ED with UA and admitted to a coronary care unit over a 2 month period. They found that the admission diagnosis of ischaemic cardiac pain (MI, UA or angina) was confirmed in 80% of cases.…”

Clinical features in the emergency department can identify patients with suspected acute coronary syndromes who are safe for care in unmonitored hospital beds

“…The development of the Western Hospital Chest Pain Protocol (WHCPP) has taken place over several years. Its development and a pilot validation have been reported previously 5−7 . It identifies patients in the emergency department (ED) who require hospital admission for evaluation and treatment of suspected ACS and who, based on clinical, ECG and biochemical data, are at low risk of cardiac events during hospitalization.…”