Difference between revisions of "ACS (Acute Coronary Syndome) in the Emergency Department"

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== Inpatient Cardiac Services ==
 
== Inpatient Cardiac Services ==
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* The inpatient medical ward does not provide continuous telemetry monitoring and is not staffed by nursing with coronary unit experience.
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* The inpatient medical ward accepts patients with stable cardiac conditions or those who do not require continuous telemetry monitoring (such as CHF exacerbations, atrial fibrillation, etc.).
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* The inpatient medical ward cannot admit patients with ACS or with other conditions associated with a high risk for life-threatening arrhythmias.
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== Disposition Options ==
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Except in unusual circumstances, patients are not admitted to "rule-out MI."  Patients undergoing an ACS work-up are either discharged to outpatient follow-up or transferred to a facility with a higher level of inpatient cardiac care.
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Revision as of 03:59, 14 February 2020

The diagnosis and management of ACS (Acute Coronary Syndrome) in the YKDHR Emergency Department has several peculiarities owing being 400 miles from the next highest level of care (Anchorage) and having limited inpatient capabilities for cardiac patients.


Inpatient Cardiac Services

  • The inpatient medical ward does not provide continuous telemetry monitoring and is not staffed by nursing with coronary unit experience.
  • The inpatient medical ward accepts patients with stable cardiac conditions or those who do not require continuous telemetry monitoring (such as CHF exacerbations, atrial fibrillation, etc.).
  • The inpatient medical ward cannot admit patients with ACS or with other conditions associated with a high risk for life-threatening arrhythmias.


Disposition Options

Except in unusual circumstances, patients are not admitted to "rule-out MI." Patients undergoing an ACS work-up are either discharged to outpatient follow-up or transferred to a facility with a higher level of inpatient cardiac care.


Transfers

Beneficiaries

Urgent PCI required (typically for STEMI)
Beneficiaries requiring URGENT PCI are transferred to either Alaska Regional Hospital or Providence Alaska Medical Center.
NOT requiring Urgent PCI
Beneficiaries requiring a higher level of care but who will wait one or two days until angiography/PCI are transferred to ANMC (Alaska Native Medical Center).

Non-beneficiaries

All non-beneficiaries who require a higher level of care must be transferred to either Alaska Regional Hospital or Providence Alaska Medical Center.


ACS Guidelines

Date Guideline Revision Notes Status
06/22/2011 Guideline None Active
2020 Pending 2020 Revision Notes In process

A File