快速访问澳大利亚和新西兰的胸痛诊所
Kenneth K Cho1, John K French1, Gemma A Figtree2,3
1Liverpool Hospital, Sydney, NSW.
The Medical journal of Australia
|August 6, 2023
概括
快速访问的胸痛诊所安全地评估低风险患者作为住院治疗的门诊替代方案,降低成本. 需要进一步的研究来确定最有效的临床模型,并建立一个国家框架.
科学领域:
- 心脏病学 心脏病学
- 紧急医疗 紧急医疗
- 医疗保健服务研究 医疗服务研究
背景情况:
- 胸部疼痛是急诊室访问的主要原因之一.
- 低风险和中等风险的胸痛患者通常被录取进行评估.
- 这导致了医疗保健的大量利用和成本.
研究的目的:
- 评估快速访问胸痛诊所 (RACPC) 的安全性和有效性.
- 探索RACPC模型的变化,并确定最佳方法.
- 倡导基于证据和最佳实践的RACPC国家框架.
主要方法:
- 对RACPC模型现有文献的审查.
- 分析多中心数据以了解服务交付.
- 对不同RACPC结构进行比较的有效性研究.
主要成果:
- RACPCs为低风险和中等风险的胸痛提供了安全和成本效益的门诊途径.
- 现有的RACPC模型显示实施的变化.
- 目前仅有有限的数据可以确定最有效的RACPC方法.
结论:
- 对于部分胸痛患者来说,RACPCs是住院治疗的可行替代方案.
- 通过国家框架进行标准化,可以提高RACPC的有效性和监测.
- 进一步的多中心数据分析对于优化RACPC服务至关重要.
相关概念视频
Angina III: Clinical Manifestations and Assessment
10
Angina manifests as chest pain, tightness, or squeezing discomfort typically located behind the breastbone. It can radiate to the neck, jaw, shoulders, and inner aspects of the upper arms, most commonly the left arm. Patients may experience shortness of breath, fatigue, profuse sweating, dizziness, indigestion, heartburn, palpitations, anxiety, and vomiting as accompanying symptoms. This pain often lasts a few minutes and is triggered by physical exertion, emotional stress, heavy meals, or cold...
10
Acute Coronary Syndrome V: Nursing Management
17
Nursing Assessment:Nursing management of acute coronary syndrome (ACS) involves taking the patient's history, focusing on primary complaints such as chest pain, dyspnea, and excessive sweating (diaphoresis), as well as other symptoms like back or jaw pain, nausea, vomiting, palpitations, dizziness, and fatigue. The nurse also reviews the patient's history of cardiac events, risk factors such as hypertension, diabetes, smoking, family history, and current medications.In the objective assessment,...
17
Angina II: Classification
7
Angina, also known as angina pectoris, is a chest pain resulting from diminished blood flow to the heart muscle and is often a symptom of coronary artery disease. Angina presents several variants with distinctive attributes, etiologies, and therapeutic approaches. The main types of angina include stable, unstable, variant (Prinzmetal's), microvascular, intractable, and silent ischemia.Stable angina is caused by atherosclerosis, which leads to the formation of plaques that narrow the coronary...
7
Acute Coronary Syndrome III: Diagnostic Studies
10
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
10
Acute Coronary Syndrome IV: Interprofessional Care
12
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
12
Aneurysm II: Clinical Manifestations and Diagnostic Studies
10
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
10


