DO n O t write in this bin D ing margin D O nO t w rite in this bin D ing margin

DO n O t write in this bin D ing margin D O nO t w rite in this bin D ing margin Intermed Iate rI sk Chest P aIn Cl In IC al P athw ay - additional Page

ÌSW030cOÎ

all care givers who initial are to sign signature log Key Allied Health Medical Nursing Pharmacy

Category DAy 2 Date: to Shift: AM PM ND V

Reviews discharge planning commenced yes no Investigations

(if not completed on the previous day)

second tnI positive? yes no

st - t waves changes at 6 to 8 hours? yes no

If yes to either of the above, refer for Cardiology / Physician Registrar review, change to NSTEACS pathway.

If further chest pain, administer glyceryl trinitrate (if not contraindicated), organise medical review (within 10 mins) and perform eCG

est request form

If EST inappropriate, consider alternate objective testing. Complete EST or alternate testing within 72 hours of presentation.

est time booked:... date: ...

results: Positive (change to NSTEACS pathway) negative equivocal Unable to complete not done, reason: ...

Medications and Pain Management

review medications

Observations

Treatments Continuous cardiac monitoring (where available)

Cease continuous cardiac monitor if the second tnI is negative.

Pulse, resps and BP frequent if unstable then 4 hourly deep breathing, coughing and leg exercises

Physical assessment (document in medical record) Nutrition Consider appropriate preparation for investigations:

If for est avoid food for 2 hours prior to test If for mPs, no caffeine 24 hours prior to test

Other: ...

healthy heart / special requirements: ...

Mobility / Elimination / Hygiene

toilet privileges and bed rest or equivalent

may mobilise after medical review if second tnI normal, painfree and eCGs nad.

Education and Discharge Plan

Basic explanation of mobilisation and bed exercises

explanation of: Coronary artery disease (Cad) risk factors

Basic cardiac a&P Potential investigations Provide heart Foundation booklet or similar

Expected Outcome (complete at end of 24 hour period)

Patient demonstrates: A – Achieved V – Variance A V

no further chest pain

haemodynamically stable post cardiac investigations Cardiac rhythm stable post cardiac investigations

Patient verbalises understanding of diagnosis and treatment

(Affix identification label here) Urn:

Family name:

Given name(s):

address:

date of birth: sex: m F I

Intermediate Risk Chest Pain Clinical Pathway

(Additional Page)

Facility:

© the state of Queensland (Queensland health) 2012 Contact CIm@health.qld.gov.au

DO n O t write in this bin D ing margin D O nO t w rite in this bin D ing margin

all care givers who initial are to sign signature log Key Allied Health Medical Nursing Pharmacy

Category DAy 2 Date: to Shift: AM PM ND V

Reviews discharge planning commenced yes no Investigations

(if not completed on the previous day)

second tnI positive? yes no

st - t waves changes at 6 to 8 hours? yes no

If yes to either of the above, refer for Cardiology / Physician Registrar review, change to NSTEACS pathway.

If further chest pain, administer glyceryl trinitrate (if not contraindicated), organise medical review (within 10 mins) and perform eCG

est request form

If EST inappropriate, consider alternate objective testing. Complete EST or alternate testing within 72 hours of presentation.

est time booked:... date: ...

results: Positive (change to NSTEACS pathway) negative equivocal Unable to complete not done, reason: ...

Medications and Pain Management

review medications

Observations

Treatments Continuous cardiac monitoring (where available)

Cease continuous cardiac monitor if the second tnI is negative.

Pulse, resps and BP frequent if unstable then 4 hourly deep breathing, coughing and leg exercises

Physical assessment (document in medical record) Nutrition Consider appropriate preparation for investigations:

If for est avoid food for 2 hours prior to test If for mPs, no caffeine 24 hours prior to test

Other: ...

healthy heart / special requirements: ...

Mobility / Elimination / Hygiene

toilet privileges and bed rest or equivalent

may mobilise after medical review if second tnI normal, painfree and eCGs nad.

Education and Discharge Plan

Basic explanation of mobilisation and bed exercises

explanation of: Coronary artery disease (Cad) risk factors

Basic cardiac a&P Potential investigations Provide heart Foundation booklet or similar

Expected Outcome (complete at end of 24 hour period)

Patient demonstrates: A – Achieved V – Variance A V

no further chest pain

haemodynamically stable post cardiac investigations Cardiac rhythm stable post cardiac investigations

Patient verbalises understanding of diagnosis and treatment

(Affix identification label here) Urn:

Family name:

Given name(s):

address:

date of birth: sex: m F I

Intermediate Risk Chest Pain Clinical Pathway

(Additional Page)