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.
- Direct acquisition of ECG by triage staff
- Via direct request to an ED/CPC tech
- Rapid transfer of patient to the main ED area for stat ECG
- 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
- Any available Chest Pain Center Bed
- Any available adult care bed
- Any available hallway care space
- 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.