Clinical Tool Identifies Patients Who Do Not Require Cardiac Monitoring
By HospiMedica International staff writers Posted on 08 Feb 2017 |
Image: Dr. Venkatesh Thiruganasambandamoorthy of Ottawa Hospital (Photo courtesy of Ottawa Hospital).
Emergency departments (EDs) have a new clinical decision tool to identify patients with chest pain who can be removed safely from cardiac monitoring, according to a new study.
Researchers at Ottawa Hospital and the University of Ottawa conducted a prospective study involving 796 patients (mean age 63.8 years, 55.8% male) who presented to the ED with chest pain, in order to validate the Ottawa Chest Pain Cardiac Monitoring Rule, a decision tool for safe removal of patients from cardiac monitoring after an initial evaluation in the ED. The researchers collected baseline characteristics, clinical evaluations, and patient predictors, such as electrocardiogram (ECG) readings.
The researchers then calculated diagnostic characteristics for the clinical prediction rule. The outcome was a tool that helps identify arrhythmia requiring intervention while in the ED, or within eight hours of presentation. Study results showed that of all the patients monitored, only 1.9% suffered an arrhythmia during their stay in the ED. Following the new rule would have enabled 284 (35.7%) of these patients to be safely removed from cardiac monitoring. The study was published on January 30, 2016, in the Canadian Medical Association Journal (CMAJ).
“Overall, the management of chest pain patients has not changed much in the past 10 years, with most patients requiring serial blood tests to rule out heart attack and end up staying in the emergency department for few hours,” said senior author Venkatesh Thiruganasambandamoorthy, MD, PhD. “A substantial number of patients are unnecessarily being placed on cardiac monitoring, while this resource is needed for patients in the waiting room who are more ill.”
“We recommend that patients who present to the emergency department with chest pain be removed from cardiac monitoring if they are free of chest pain at the time of assessment, and if the ECG is either normal or shows only nonspecific changes,” concluded Dr. Thiruganasambandamoorthy and colleagues. “The results, if implemented, should have a significant and positive impact on wait times and increase the availability of monitored beds for sicker patients.”
Researchers at Ottawa Hospital and the University of Ottawa conducted a prospective study involving 796 patients (mean age 63.8 years, 55.8% male) who presented to the ED with chest pain, in order to validate the Ottawa Chest Pain Cardiac Monitoring Rule, a decision tool for safe removal of patients from cardiac monitoring after an initial evaluation in the ED. The researchers collected baseline characteristics, clinical evaluations, and patient predictors, such as electrocardiogram (ECG) readings.
The researchers then calculated diagnostic characteristics for the clinical prediction rule. The outcome was a tool that helps identify arrhythmia requiring intervention while in the ED, or within eight hours of presentation. Study results showed that of all the patients monitored, only 1.9% suffered an arrhythmia during their stay in the ED. Following the new rule would have enabled 284 (35.7%) of these patients to be safely removed from cardiac monitoring. The study was published on January 30, 2016, in the Canadian Medical Association Journal (CMAJ).
“Overall, the management of chest pain patients has not changed much in the past 10 years, with most patients requiring serial blood tests to rule out heart attack and end up staying in the emergency department for few hours,” said senior author Venkatesh Thiruganasambandamoorthy, MD, PhD. “A substantial number of patients are unnecessarily being placed on cardiac monitoring, while this resource is needed for patients in the waiting room who are more ill.”
“We recommend that patients who present to the emergency department with chest pain be removed from cardiac monitoring if they are free of chest pain at the time of assessment, and if the ECG is either normal or shows only nonspecific changes,” concluded Dr. Thiruganasambandamoorthy and colleagues. “The results, if implemented, should have a significant and positive impact on wait times and increase the availability of monitored beds for sicker patients.”
Latest Critical Care News
- Wheeze-Counting Wearable Device Monitors Patient's Breathing In Real Time
- Wearable Multiplex Biosensors Could Revolutionize COPD Management
- New Low-Energy Defibrillation Method Controls Cardiac Arrhythmias
- New Machine Learning Models Help Predict Heart Disease Risk in Women
- Deep-Learning Model Predicts Arrhythmia 30 Minutes before Onset
- Breakthrough Technology Combines Detection and Treatment of Nerve-Related Disorders in Single Procedure
- Plasma Irradiation Promotes Faster Bone Healing
- New Device Treats Acute Kidney Injury from Sepsis
- Study Confirms Safety of DCB-Only Strategy for Treating De Novo Left Main Coronary Artery Disease
- Revascularization Improves Quality of Life for Patients with Chronic Limb Threatening Ischemia
- AI-Driven Prediction Models Accurately Predict Critical Care Patient Deterioration
- Preventive PCI for High-Risk Coronary Plaques Reduces Cardiac Events
- AI Diagnostic Tool Guides Rapid Diagnosis and Prediction of Sepsis
- World's First AI-Powered Sepsis Alert System Detects Sepsis in One Minute
- Smartphone Magnetometer Uses Magnetized Hydrogel to Measure Biomarkers for Disease Diagnosis
- New Technology to Revolutionize Valvular Heart Disease Care