12-lead ECG interpretation and chest pain management: 1

The National Service Framework for Coronary Heart Disease provides guidance on important aspects of therapy that may make a substantial difference to patient care (Department of Health (DoH), 2001). It highlights the need to identify and fast-track patients with an acute coronary syndrome so that thrombolysis or appropriate interventional care can take place as soon as possible, to optimize myocardial salvage and reduce door-to-needle time (DoH, 2001; Castle, 2002). It is therefore extremely important that nurses in acute clinical areas are able to record and interpret 12-lead electrocardiograms so that the treatment modality can be initiated as soon as possible, leading to better clinical outcomes for this patient group. Although nurses work within a healthcare team, it is often the nurse who initially assesses, implements and coordinates care for patients with chest pain, be it in the emergency department, cardiac unit, general ward setting or general practice.