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

Kelly, Anne-Maree and Kerr, Debra (2004) Clinical features in the emergency department can identify patients with suspected acute coronary syndromes who are safe for care in unmonitored hospital beds. Internal Medicine Journal, 34 (11). pp. 594-597. ISSN 1444-0903

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Abstract

Background: Standard practice for patients requiring hospital admission with suspected acute coronary syndromes (ACS) is admission to a monitored cardiology bed. The Western Hospital Chest Pain Protocol was developed to identify a subset of these patients who could be safely managed in an unmonitored bed. Aim: The objective of this prospective study of chest pain patients classified as ‘high’ or ‘intermediate’ risk by the Agency for Health Care Policy and Research/National Health and Medical Research Council guidelines was to further evaluate the safety of this protocol. Methods: This study was a prospective, observational, cohort study investigating the outcomes of patients admitted to hospital with suspected ACS. The primary outcome of interest was death or life-threatening arrhythmia within 24 h of hospital admission. Results: If the Western Hospital Chest Pain Protocol had been strictly applied, there would have been one death in the group assigned to unmonitored beds (1/750; 0.13%, 95% confidence interval 0.01−0.85%) and no other life-threatening arrhythmias. Conclusion: There is a subgroup of patients with suspected ACS who require hospital admission who can, based on clinical and biochemical features in the emergency department, be safely assigned to unmonitored beds.

Item Type: Article
Uncontrolled Keywords: ResPubID19033, chest pain, monitoring, risk stratification
Subjects: FOR Classification > 1110 Nursing
FOR Classification > 1199 Other Medical and Health Sciences
Faculty/School/Research Centre/Department > School of Nursing and Midwifery
Depositing User: VUIR
Date Deposited: 01 Feb 2012 05:32
Last Modified: 03 May 2013 01:00
URI: http://vuir.vu.edu.au/id/eprint/2610
DOI: 10.1111/j.1445-5994.2004.00650.x
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Citations in Scopus: 8 - View on Scopus

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