Short Stay Management of Chest Pain / Edition 1

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Overview

Acute coronary syndrome (ACS) continues to challenge our health care system in the complexity of presentation and the ever increasing number of patients exhibiting signs and symptoms of an acute coronary syndrome. Written by leading experts, Short Stay Management of Chest Pain provides scientific and clinical insights on the management of patients who arrive at the hospital with a presentation consistent with a potential acute coronary syndrome. Focusing on the cardiology aspects of chest pain, Short Stay Management of Chest Pain is a valuable tool for acute care physicians, nurses, and hospital administrators devoted to caring for this population. Short Stay Management of Chest Pain details the remarkable improvements in diagnostic accuracy and improved patient outcomes for patients presenting with suspected acute coronary syndromes.

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Product Details

  • ISBN-13: 9781603279475
  • Publisher: Springer-Verlag New York, LLC
  • Publication date: 7/1/2009
  • Series: Contemporary Cardiology Series
  • Edition number: 1
  • Pages: 284
  • Sales rank: 890,217
  • Product dimensions: 6.30 (w) x 9.40 (h) x 0.90 (d)

Table of Contents

I. Introduction 2 Peacock

II. Epidemiology and Demographics of Coronary Artery Disease 5 Dadkah

III. Financial Impact of Chest Pain 10 Sieck

a. US costs

b. Economic case for a short stay unit

IV. Why have a chest pain unit? 10 Toth

a. QI data

b. Outcomes data

c. Financial aspects

V. Pathophysiology and Definition of ACS 10 Amsterdam

a. Unstable Angina

b. NSTEMI

c. STEMI

VI. Emergency Department presentation 10 Collins

a. Common presentations

b. Confounders (gender, age, etc)

c. Differential diagnosis

d. Guideline recommendations 5

i. ECG time

ii. Marker turn around time

VII. Risk Stratification Storrow

a. History and Physical 5

b. ECG 12

i. 12 lead

ii. Future developments

c. Cardiac Markers 15 Christianson

i. Necrosis markers

1. Troponin I/T

2. CKMB

3. Myoglobin

4. Future developments

ii. Ischemia markers

1. Ischemia Modified Albumin

2. Myeloperoxidase (MPO)

3. Future developments

iii. Point of care vs lab

iv. Confounders

1. Renal failure

2. Recent cardiac procedures

3. Re-infarction

v. Panels

vi. Future developments

d. Scoring systems 10 Hollander

i. TIMI

ii. ACI-TIPI

iii. Richmond

VIII. Emergency Department Disposition 15 Diercks

a. Catheterization lab

i. Indications

ii. Guidelines

b. Hospitalization

c. Short Stay Unit

i. Inclusion criteria

ii. Exclusion criteria

d. Home

IX. Short Stay Unit Requirements 20 Graff

a. Monitoring

i. Telemetry

ii. Continuous ST segment monitoring

iii. Future developments

b. Staffing requirements

i. Physician

ii. Nursing

c. Regulatory (JCAHO)

X. Medical Therapy while awaiting testing/results 20 McCord

a. Aspirin

b. Antithrombin therapy

c. Topical nitrates

d. Beta blockade

XI. Evocative testing 30 Kirk/Amsterdam

a. General principals

i. Candidate selection for stress testing

ii. Immediate vs delayed

b. Exercise stress testing

i. Heart rate recovery

c. Myocardial perfusion imaging

i. Thallium

ii. Technetium sestamibi

iii. PET scanning

d. Echocardiography

e. Pharmacologic adjuncts

i. Dobutamine ii. Persantine

iii. adenosine

f. Future developments

i. CT Scanning O'Neil

XII. Disposition from the short stay unit 15 Garvey

a. Indications for hospitalization from the short stay unit i. Cardiac markers

1. Serial changes

ii. ECG changes

iii. Stress testing

1. Who can be discharged with a positive stress test

XIII. Patient discharge instructions 15 Kay Holmes

a. Example

b. Example

c. Example

XIV. ACS Rule out prools 15 Kay Holmes

a. Example

b. Example

c. Example

XV. Order sheets 15 Kay Holmes

a. Example

b. Example

c. Example

Total pages 239

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