Risk for ACS Flowsheet

Patient presents to ED with Chest Pain Patient Quick Registered

STEMI or NSTEMI/UA Protocol as appropriate

EKG to ED Physician within 10 minutes of completion

No

Clinical Assessment of Low Risk

Yes

Initiate TRACK III Protocol in Treatment Room

Meds: ASA, Ntg; Consider Beta Blocker; O2, IV

Blood drawn for Cardiac Marker testing

Radiology for PA & Lat Chest

Transfer to CICU

Yes

Stress Test Positive?

Nuclear Test Interpreted by Cardiologist

Perform Echocardiogram, Stress Test, Serial EKGs & Enzymes

Yes
Admit to CDU?

No No
Cath Indicated

No Yes No
CABG Indicated

PCI Indicated

Yes

Dismiss with medical management & follow-up instructions.

Yes
Perform CABG Surgery

Perform PCI

Transfer to CTICU

Transfer to Telemetry Additional testing & monitoring as indicated by patients condtion

VCRMC - SFC

November 2009