scholarly journals Evaluating Disparities Affecting Time from Emergency Department Door to Electrocardiogram in Chest Pain Patients

2020 ◽  
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Heart Association ◽  
Chief Complaint ◽  
Primary Language ◽  
Diverse Patient Population ◽  
Race Ethnicity ◽  
Mean Time ◽  
Pain Patients ◽  
Urban Emergency Department

Introduction: For patients presenting to an emergency department with a chief complaint of chest pain, current American Heart Association guidelines recommend that time from emergency department arrival to completion of electrocardiogram be 10 minutes or less. The aim of this study is to evaluate if differences still exist amongst a diverse patient population presenting to a busy urban emergency department with a chief complaint of chest pain. Methods: This retrospective study looked at 3,419 patients who presented to the Emergency Department with any complaint of chest pain during the medical screening examination. Arrival time and time of first electrocardiogram along with age, gender, race, ethnicity and primary language were extracted from electronic health records. Results: For all patients, the mean time to electrocardiogram was 12.5 minutes (95% CI: 12.1-12.7) and 49.9% of all patients received an electrocardiogram within 10 minutes of arrival. Mean time for men was 11.6 minutes and for women 13.3 minutes (P<0.0001); in addition 54% of men and 44.4% of women had electrocardiogram done within 10 minutes of arrival (P<0.0001). No differences were found with regards to primary language, race or ethnicity of patients. Mean time to electrocardiogram for patients less than 40 years old was 14.6 minutes, which was significantly longer than patients equal or older than 40 years, who’s mean time was 11.9 minutes (p<0.0001). The effect of age was observed across gender, race, ethnicity and primary language spoken by the patients. Conclusions: Patient presenting to the emergency department with chest pain are subject to several biases that potentially create health disparities. In this study we show that younger patients and women had a delay in time to electrocardiogram showing biases are still an issue.

Measuring Patient Tolerance for Future Adverse Events in Low-Risk Emergency Department Chest Pain Patients

2014 ◽  
Vol 64 (2) ◽  
pp. 127-136.e3 ◽  
Author(s):  
Jennifer C. Chen ◽  
Richelle J. Cooper ◽  
Ana Lopez-O'Sullivan ◽  
David L. Schriger
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Adverse Events ◽  
Low Risk ◽  
Patient Tolerance ◽  
Pain Patients

Utility of Routine Exercise Stress Testing among Intermediate Risk Chest Pain Patients Attending an Emergency Department

2015 ◽  
Vol 24 (9) ◽  
pp. 879-884 ◽  
Author(s):  
Jaimi H. Greenslade ◽  
William Parsonage ◽  
Ariel Ho ◽  
Adam Scott ◽  
Emily Dalton ◽  
...  
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Stress Testing ◽  
Exercise Stress ◽  
Exercise Stress Testing ◽  
Intermediate Risk ◽  
Pain Patients

scholarly journals High-sensitivity troponin assays in the evaluation of patients with acute chest pain in the emergency department

2011 ◽  
Vol 49 (12) ◽  
Author(s):  
Michael Christ ◽  
Thomas Bertsch ◽  
Steffen Popp ◽  
Philipp Bahrmann ◽  
Hans-Jürgen Heppner ◽  
...  
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Emergency Physician ◽  
Acute Chest Pain ◽  
High Sensitivity ◽  
Clinical Work ◽  
Life Threatening ◽  
Acute Mi ◽  
Minor Disease ◽  
Pain Patients

AbstractEvaluating patients with acute chest pain presenting to the emergency department remains an ongoing challenge. The spectrum of etiologies in acute chest pain ranges from minor disease entities to life-threatening diseases, such as pulmonary embolism, acute aortic dissection or acute myocardial infarction (MI). The diagnosis of acute MI is usually made integrating the triad of patient history and clinical presentation, readings of 12-lead ECG and measurement of cardiac troponins (cTn). Introduction of high-sensitivity cTn assays substantially increases sensitivity to identify patients with acute MI even at the time of presentation to the emergency department at the cost of specificity. However, the proportion of patients presenting with cTn positive, non-vascular cardiac chest pain triples with the implementation of new sensitive cTn assays increasing the difficulty for the emergency physician to identify those patients who are at need for invasive diagnostics. The main objectives of this mini-review are 1) to discuss elements of disposition decision made by the emergency physician for the evaluation of chest pain patients, 2) to summarize recent advances in assay technology and relate these findings into the clinical context, and 3) to discuss possible consequences for the clinical work and suggest an algorithm for the clinical evaluation of chest pain patients in the emergency department.

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