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Chest Pain Guidelines
ACS Cardiac Pathway
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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
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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
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Low to Moderate Risk Stratification Tool
The Low to Moderate Risk Stratification
Tool will be used for those patients with
heart scores 0-6
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The Unstable Angina/NSTEMI Stratification Tool
A high risk stratification tool for those
patients whose heart score is greater than 7
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What’s New with Chest Pain
Patients?
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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!
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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.
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Inpatient Providers
Inpatient Providers can
perform Heart Score
from Admission, Daily
Progress note or as a
stand alone document
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ED Flowcharts
ACS Cardiac Pathway
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Inpatient Stemi Flowchart
ACS Cardiac Pathway
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INPATIENT
What do to if a patient has new onset
chest pain
ACS Cardiac Pathway
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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
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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