Although bedside monitors are used in assessing ECG rhythm, vital signs, and other parameters in patients with clinical presentations suggestive of myocardial ischemia, surveys suggest that the C-STM feature is not commonly activated. They are, therefore, largely responsible for determining the urgency with which patients receive medical attention, and for monitoring their condition while in the ED. hospitals, amounting to $11.5 billion in aggregate hospital costs and up to 612,000 hospital discharges ( Torio & Andrews, 2013).Įmergency nurses are generally the first health care providers to evaluate patients presenting with signs and symptoms of ischemia or myocardial infarction. In 2011, acute myocardial infarction was the fifth most expensive condition in U.S. There are an estimated 635,000 new cases of myocardial infarction and 300,000 recurrent cases in the U.S. It is a chief manifestation of coronary heart disease, which caused one in every six deaths in the U.S. More than 8 million ED visits are associated with chest pain and other signs and symptoms of myocardial ischemia ( Amsterdam et al., 2010). A Class IIb recommendation signifies that although more studies on this technology are needed, the procedure may be considered, as its benefits far outweigh any risks involved in its use. ![]() The Task Force considered C-STM to be a reasonable alternative to serial 12-lead ECGs for ruling out myocardial ischemia in patients. In addition, C-STM has been assigned as a Class IIb recommendation by the American College of Cardiology (ACC)/American Heart Association (AHA) Task Force on Practice Guidelines for the Management of Patients with Non-ST-Elevation Acute Coronary Syndromes ( Amsterdam et al., 2014) for patients in whom the initial electrocardiogram (ECG) is not diagnostic. The ST-Segment Monitoring Practice Guideline International Working Group ( Drew & Krucoff, 1999) also recommends C-STM for patients in the ED at risk for myocardial ischemia. ![]() The Practice Standards for Electrocardiographic Monitoring in Hospital Settings ( Drew et al., 2004) recommend continuous ST-segment monitoring (C-STM) for 8 to 12 hours in combination with serum biomarker testing as a cost-effective strategy for determining the priority of treatment in patients who present to the emergency department (ED) with signs and/or symptoms of acute coronary syndrome (ACS).
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