SBAR: Administrative Policy and Procedure regarding STEMI patients

By Jon Stallkamp, MD, vice president of Medical Affairs, Riddle Hospital

Starting December 4, patients with hemodynamically stable ST elevation MIs will be admitted to the PCU.

SITUATION

Hemodynamically stable STEMIs can safely be admitted to the PCU

BACKGROUND

Historically, all STEMIs were placed in the ICU. With advances in cardiac care most STEMI patients don’t need aggressive 1:1 or 2:1 nursing care. Other health systems around the country are admitting STEMI patients outside of the ICU environment. Cardiology and critical care leadership at Riddle all feel comfortable with STEMIs in the PCU.

ASSESSMENT

In order to safely transition to STEMI patients in the PCU, the educator of ICU/PCU will educate the PCU staff about the care of the STEMI patient

RECOMMENDATION

Beginning on December 4, the default unit for all STEMIs will be the PCU. While in the Cath Lab, the Interventionalist may change the admit order to the ICU if the patient is not hemodynamically stable or needing  advanced hemodynamic monitoring that is not available in the PCU.

 

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