Action
Abnormal ECG and/or medium- to high-risk on Marburg Heart Score or HEAR Score
Consider all clinical findings (eg, ECG results, age and/or pre-existing risk factors elevating baseline score).
Decision
Is disposition to the ED appropriate?
Yes
- Transport to ED via ambulance
- Send ECG result with patient
- Consider administration of oral aspirin chewed)
- Consider sublingual nitroglycerin
- Sublingual nitroglycerin may be administered for ongoing pain in patients with normal or high blood pressure. Many sources recommend securing intravenous access prior to administration of sublingual nitroglycerin due to the resultant drop in blood pressure.
No
- Patient may complete clinic registration to be seen in order of check-in or may complete clinic office visit
