Triage Indicators of the Patients with Acute Coronary Syndrome (ACS) in the Emergency Department (ED)

Abstract

CILJ ISTRAŽIVANJA: Utvrditi trijažne indikatore u bolesnika s akutnim koronarnim sindromom zaprimljenih na Objedinjeni hitni bolnički prijem Opće bolnice Zadar u razdoblju od 1. srpnja 2020. do 31 prosinca 2020. godine kao i prikazati važnost medicinske sestre/tehničara na poslovima trijaže. USTROJ STUDIJE: Retrospektivna stručna istraživačka studija. ISPITANICI I METODE: Istraživanje je izvršeno nad bolesnicima oboljelima od AKS-a, zaprimljenih na Objedinjeni hitni bolnički prijem Opće bolnice Zadar u razdoblju od 1. srpnja 2020. do 31. prosinca 2020. godine. Istraživanjem je obuhvatilo 187 oboljelih, od kojih 134 muškaraca i 53 žene. REZULTATI: Prosječna dob oboljelih od AKS-a je 68 godina. Muški spol češće obolijeva od AKS-a nego ženski. U OHBP je 13 bolesnika dovezeno sanitetskim prijevozom, 87 bolesnika je došlo samostalno u hitni prijem, a 87 je dovezla hitna medicinska pomoć. Prosječno vrijeme čekanja ispitanika od dolaska u hitni prijem do trijažiranja je dvije minute. U prvoj trijažnoj kategoriji kategorizirano je pet bolesnika, u drugoj 49 bolesnika, u trećoj 105 bolesnika, u četvrtoj 25 bolesnika, a u petoj, najmanje hitnoj, kategorizirana su dva bolesnika. Unutar određenih trijažnih kategorija, prosječno vrijeme provedeno čekajući na početak pregleda liječnika za prvu trijažnu kategoriju iznosi osam minuta, za drugu dvije minute, za treću 22 minute, za četvrtu 36 minuta, a za dva pacijenta iz pete kategorije vrijeme nije ispravno upisano. ZAKLJUČAK: Akutni koronarni sindrom je hitno stanje koje predstavlja kritičnu ishemiju miokarda i kao takav zahtijeva hitno zbrinjavanje. Medicinske sestre i tehničari predstavljaju neizostavan dio tima pri zbrinjavanju AKS-a na svim razinama zdravstvene zaštite. Prva osoba s kojom se pacijent susreće pri dolasku u bolničku hitnu službu upravo je medicinska sestra koja provodi trijažu. Utvrđena trijažna odluka ima utjecaj na kliničke ishode bolesnika. Stoga je važno da medicinske sestre i tehničari budu educirani, da posjeduju znanja i vještine o provođenju postupka trijaže te važnosti ranog prepoznavanja ACS kako bi doprinijeli pozitivnom ishodu za bolesnika.RESEARCH OBJECTIVE: To determine triage indicators in patients with acute coronary syndrome admitted to the Emergency Hospital Admission of the Zadar General Hospital in the period from July 1, 2020 to December 31, 2020 as well as to show the importance of the nurses during the medical procedure. STUDY STRUCTURE: A retrospective research study. SUBJECTS AND METHODS: The study included patients with ACS, admitted to the Emergency Hospital Admission of the Zadar General Hospital during the period from July 1, 2020 to December 31, 2020. The study included 187 patients (134 male and 53 female). RESEARCH RESULTS: The average age of patients with ACS is 68 years. Male patients more often suffer from ACS in comparison to female patients. In ER, 13 patients were brought by regular hospital vehicles, 87 patients came to the emergency room on their own, and 87 were brought by ambulance. The average waiting time of respondents from arrival at the emergency room to triage is two minutes. Five patients required the first level triage, the second level included 49 patients, the third 105 patients, the fourth 25 of them, and in the fifth, the least urgent one, there were 2 patients. Within certain triage categories, the average waiting time for the first category patients is 0 minutes, for the second it is 2 minutes, for the third it is 22 minutes, for the fourth it is 36 minutes, and for 2 patients from the fifth category the time is not entered correctly. CONCLUSIVE REMARKS: Acute coronary syndrome is an emergency condition that represents critical myocardial ischemia and as such requires urgent care. Nurses are an indispensable part of the team at all levels of ACS medical care. The triage nurse is the first person the patient meets on arrival at the hospital emergency department. The established triage decision has an impact on the patient’s clinical outcomes. It is therefore important that nurses are educated, that they possess the knowledge and skills to conduct the triage procedure, and the importance of early recognition of ACS to contribute to a positive outcome for the patient