Chest Pain Guidelines

ACS Cardiac Pathway

What is the Heart Score

A tool that provides a quick

and reliable predictor of

outcomes in chest pain

patients

The physicians will

determine the heart score

Photo courtesy of http://www.heartscore.nl/score

Heart Score

Based on the Heart Score the patient will either fall into the

Low-Moderate Risk Stratification Tool or the High Risk

Stratification Tool

These tools will help aid in the decision making process and to

help determine the strategies to assure the patient gets the

appropriate care

Low to Moderate Risk Stratification Tool

The Low to Moderate Risk Stratification

Tool will be used for those patients with

heart scores 0-6

The Unstable Angina/NSTEMI Stratification Tool

A high risk stratification tool for those

patients whose heart score is greater than 7

What’s New with Chest Pain

Patients?

Serial Troponin and EKG

Per new Chest Pain Guidelines Serial Troponins

will be timed at hour Zero (initial), hour Three,

and hour Six

Serial EKGs will be at hour Zero and hour Six

These are NOT to be retimed!

Providers will be responsible for documenting Heart Score.

This will be done through Physician Documentation.

ED Providers

Providers will

choose if pt

has chest pain

. If answer of

yes , then

Heart score

will be

required.

Inpatient Providers

Inpatient Providers can

perform Heart Score

from Admission, Daily

Progress note or as a

stand alone document

ED Flowcharts

ACS Cardiac Pathway

Inpatient Stemi Flowchart

ACS Cardiac Pathway

INPATIENT

What do to if a patient has new onset

chest pain

ACS Cardiac Pathway

If a patient begins to have chest pain

Nursing will call a Rapid Response

Obtain Vital Signs

Nursing will make sure an EKG is performed and reviewed

by the Hospitalist attending the Rapid Response and that the

EKG is signed, dated, and timed by the hospitalist

EDM- ED ACS/ Chest Pain

Inpatient – Chest Pain/ Acute Coronary Syndrome

These are the order sets that will need to be utilized with

patients with symptoms of Acute Coronary Syndrome

Go Live Monday 3-13-2017

Order Sets