EMS Recognition Strategies

Project UPSTART “Screening ECG Process Plan”

Objective: To provide multiple options for the rapid acquisition of ECG’s on all new ED patients who meet Screening ECG criteria

Timely ECG acquisition on new ED patients presenting at triage
Rational: Triage staff are responsible for the rapid acquisition of the screening ECG on all new triage patients meeting screening criteria.
1. Direct acquisition of ECG by triage staff
2. Via direct request to an ED/CPC tech
3. Rapid transfer of patient to the main ED area for stat ECG
4. Via the use of properly trained “volunteer greeters”
Timely screening ECG acquisition by core ED nursing staff
Rational: When a nurse assumes care of an new EMS arrival or triage patient, he or she assumes responsibility for obtaining the screening ECG on that patient -either directly or via request of ancillary ED staff
Involvement of the team leader/charge nurse (fallback option #1)
Rational: When triage or ED staff are unable to obtain a timely screening ECG as required (for whatever reason) they will promptly contact the team leader who will then facilitate the screening ECG via an “any available bed” policy
1. Any available Chest Pain Center Bed
2. Any available adult care bed
3. Any available hallway care space
4. Use of other “ECG spaces” as deemed appropriate
Utilization of a “STAT ECG Tech” option (fall-back option #2)
Rational: In instances where the ED is at capacity, triage is extremely busy or nursing staff are unable to complete the screening ECG as indicated, a stat “call for ECG” may be utilized to summon the ‘Stat ECG tech”. They will be expected to assist immediately in ECG acquisition.

NOTE: timely acquisition of a screening ECG arrival within 5 minutes of arrival on all patients defined by the UPSTART Screening ECG Protocol criteria is a continuous and absolute goal of the emergency department. Patients with chest pain should be transported by wheelchair while in the department.