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. 2020 Aug;43(4):356-364.
doi: 10.1002/nur.22045. Epub 2020 Jun 3.

Exploring the complex interactions of baseline patient factors to improve nursing triage of acute coronary syndrome

Stephanie O Frisch  1   2 , Julissa Brown  1 , Ziad Faramand  1 , Jennifer Stemler  1 , Ervin Sejdić  3 , Christian Martin-Gill  2   4 , Clifton Callaway  2   4 , Susan M Sereika  5 , Salah S Al-Zaiti  1   4
Affiliations

Exploring the complex interactions of baseline patient factors to improve nursing triage of acute coronary syndrome

Stephanie O Frisch et al. Res Nurs Health. 2020 Aug.

Abstract

Emergency department (ED) nurses need to identify patients with potential acute coronary syndrome (ACS) rapidly because treatment delay could impact patient outcomes. Aims of this secondary analysis were to identify key patient factors that could be available at initial ED nurse triage that predict ACS. Consecutive patients with chest pain who called 9-1-1, received a 12-lead electrocardiogram in the prehospital setting, and were transported via emergency medical service were included in the study. A total of 750 patients were recruited. The sample had an average age of 59 years old, was 57% male, and 40% Black. One hundred and fifteen patients were diagnosed with ACS. Older age, non-Caucasian race, and faster respiratory rate were independent predictors of ACS. There was an interaction between heart rate by Type II diabetes receiving insulin in the context of ACS. Type II diabetics requiring insulin for better glycemic control manifested a faster heart rate. By identifying patient factors at ED nurse triage that could be predictive of ACS, accuracy rates of triage may improve, thus impacting patient outcomes.

Keywords: acute coronary syndrome; chest pain; emergency department; emergency nursing; triage.

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Conflict of interest statement

CONFLICT OF INTERESTS

The authors declare that there are no conflict of interests.

Figures

FIGURE 1
FIGURE 1
Interaction of mean centered first emergency department heart rate by Type II diabetics receiving insulin for glycemic control. Mean centered log base 10 transformation of first ED heart rate (mean = 84; +/−SD). ED, emergency department; SD, standard deviation
See this image and copyright information in PMC

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