![]() Do not consider “subendocardial” an MI “location” (e.g., “acute subendocardial MI” should be disregarded).If any of the Inclusion terms are described using the qualifier “possible,” disregard that finding (neither Inclusion nor Exclusion).If at least one interpretation describes an LBBB as old, chronic, or previously seen, all LBBB findings should be disregarded.If documentation is contradictory (e.g., “ST-elevation” and “No ST-elevation”), select “No.”.Disregard any description of an MI or ST segment that is not on either the Inclusion list or the Exclusion list. ![]() If ECG documentation outside of a tracing is not specified as 12-lead, assume it is 12-lead unless documentation indicates otherwise.Consider a tracing 12-lead if it has the appropriate markings (the presence of multiple leads: I, II, III, AVR, AVL, AVF, V1-V6).Do not measure ST-segments or attempt to determine if there is an LBBB from the tracing itself.Physician/APN/PA notation of ECG findings in another source (e.g., progress notes).12-lead tracing with name/initials of the physician/advanced practice nurse/physician assistant (physician/APN/PA) who reviewed the ECG signed, stamped, or typed on the report, or.At the end of your review, if you have no Exclusions, and either the signed ECG tracing or interpretations of this ECG include at least one Inclusion, select “Yes.” Otherwise, select “No.”.If you encounter an Exclusion in any of the other interpretations, select “No,” regardless of other documentation, and there is no need to review further. Do not cross reference findings between interpretations unless otherwise specified. Documentation which cannot be tied to the ECG performed closest to arrival should not be used. In the absence of an Exclusion on the tracing, proceed to other interpretations that you can say clearly refer to the closest to arrival ECG.If you have an Exclusion, select “No,” regardless of other documentation, and there is no need to review further. Determine if the terms or phrases are Inclusions or Exclusions. Start with review of your SIGNED tracing.If unable to determine which ECG was performed closest to arrival, select “No.” Identify the ECG performed closest to arrival, either before or after hospital arrival, but not more than 1 hour prior to arrival.N (No) No ST-elevation or LBBB on the interpretation of the 12-lead ECG performed closest to hospital arrival, no interpretation or report available for the ECG performed closest to hospital arrival or unable to determine from medical record documentation. Y (Yes) ST-segment elevation or a LBBB on the interpretation of the 12-lead ECG performed closest to hospital arrival. Is there documentation of ST-segment elevation or left bundle branch block (LBBB) on the electrocardiogram (ECG) performed closest to hospital arrival? LBBB may be an electrocardiographic manifestation of an AMI. In LBBB, left ventricular depolarization is delayed, resulting in a characteristic widening of the QRS complex on the ECG. A bundle branch block (BBB) results from impaired conduction in one of the branches of the conduction system between the atria and the ventricles, which in turn results in abnormal ventricular depolarization. The ST-segment, the segment between the QRS complex and the T wave, may be elevated when myocardial injury (AMI) occurs. The normal ECG is composed of a P wave (atrial depolarization), Q, R, and S waves (QRS complex, ventricular depolarization), and a T wave (ventricular repolarization). ST-segment elevation or a left bundle branch block (LBBB) based on the documentation of the electrocardiogram (ECG) performed closest to hospital arrival.
0 Comments
Leave a Reply. |
Details
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |