ED Acute Chest Pain Imaging Protocol
This protocol is for patients presenting to the ED with suspected low risk ACS
Inclusion criteria to be followed by ED for entry into protocol
Chest pain
Normal initial Troponin I
TIMI risk score 0-3
No Q waves on ECG
No significant cardiac history, including past MI stents, CABG
No other acute medical problems (i.e., active bleeding, COPD exacerbation, pneumonia, pulmonary embolism, aortic dissection, fever, etc.)
| Patient arrives to ED with ONGOING CP and fits criteria to perform nuclear chest pain imaging |
ß
Nuclear medicine tech will come to the ED and inject the patient with sestamibi within 60 minutes and EMS will transport patient to radiology department for chest images. The patient can be scanned within 3 hours of injection. The appropriate computer order is:
Myocardial Imaging Tomography Spectroscopy Single
which may be found under the Radiology/Nuclear Medicine order screen.
|
If images are positive (indicating presence of CAD or ACS) admit pt. to CACU from ED |
If the images are “Probably normal” or show attenuation artifact, the recommendation is to admit the patient for complete test. | If images are
negative, and 3 neg. troponins, the patient can be discharged to home if
clinically stable with a prescription to return for complete a stress test 48 hours
later. ß Patient returns to non-invasive cardiology as outpatient in 48 hours for complete stress test. |
Hours of operation:
Although it may be available at other hours, the usual hours
of operation are:
Monday - Friday 8A-4P
Saturday 8A-1P
|
Phone numbers:
4-5211 to arrange for first ED sestamibi study |