A randomized controlled trial of the effectiveness of “chest pain evaluation at emergency room” (cheer) protocol in the ed of HUSM: a model for Malaysian emergency departments

Background Management of low risk chest pain in adults is a problem in emergency department in Malaysia. Traditional use of CK/CKMB ratio among others has been used to manage patients presenting with low risk chest pain in Malaysia. Sometimes patients are admitted to the medical ward for observatio...

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Main Author:	Bolong @ Darwis, Mohammad Firdaus @ Mohd
Format:	Thesis
Language:	English
Published:	2020
Subjects:	R Medicine
Online Access:	http://eprints.usm.my/50251/1/Muhammad%20Firdaus%20Bolong-24%20pages1.pdf
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id	my-usm-ep.50251
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spelling	my-usm-ep.502512021-10-13T08:38:19Z A randomized controlled trial of the effectiveness of “chest pain evaluation at emergency room” (cheer) protocol in the ed of HUSM: a model for Malaysian emergency departments 2020 Bolong @ Darwis, Mohammad Firdaus @ Mohd R Medicine Background Management of low risk chest pain in adults is a problem in emergency department in Malaysia. Traditional use of CK/CKMB ratio among others has been used to manage patients presenting with low risk chest pain in Malaysia. Sometimes patients are admitted to the medical ward for observation due to the ambiguity of management of low risk chest pain thus creating overcrowding in ED or unnecessary referral and admission to the medical wards, which will occupy beds and worsen backlog of admission Methods This prospective randomised control trial included 53 patients with low risk chest pain admitted to Emergency department in Hospital USM. Patients were randomised to either a standard care arm for chest pain treatment according to current HUSM guideline or CHEER (Chest Pain Evaluation in Emergency Room) protocol arm which involves 8 hours observation with serial ECG and Troponin test. Patients information such as age, chest pain characteristics, demography, ECG findings, HEART and TIMI score were calculated during the stay. Patients were followed up after 6 weeks and 6 months to determine prevalence of Major Adverse Cardiac Event, Readmission to ED for chest pain, and their length of stay in hospital and rate of early discharge from ED. Results Study shows that CHEER protocol has overall shorter length of stay at ED or hospital and has higher early discharge rate compared to standard care. There is Background Management of low risk chest pain in adults is a problem in emergency department in Malaysia. Traditional use of CK/CKMB ratio among others has been used to manage patients presenting with low risk chest pain in Malaysia. Sometimes patients are admitted to the medical ward for observation due to the ambiguity of management of low risk chest pain thus creating overcrowding in ED or unnecessary referral and admission to the medical wards, which will occupy beds and worsen backlog of admission Methods This prospective randomised control trial included 53 patients with low risk chest pain admitted to Emergency department in Hospital USM. Patients were randomised to either a standard care arm for chest pain treatment according to current HUSM guideline or CHEER (Chest Pain Evaluation in Emergency Room) protocol arm which involves 8 hours observation with serial ECG and Troponin test. Patients information such as age, chest pain characteristics, demography, ECG findings, HEART and TIMI score were calculated during the stay. Patients were followed up after 6 weeks and 6 months to determine prevalence of Major Adverse Cardiac Event, Readmission to ED for chest pain, and their length of stay in hospital and rate of early discharge from ED. Results Study shows that CHEER protocol has overall shorter length of stay at ED or hospital and has higher early discharge rate compared to standard care. There is 2020 Thesis http://eprints.usm.my/50251/ http://eprints.usm.my/50251/1/Muhammad%20Firdaus%20Bolong-24%20pages1.pdf application/pdf en public masters Universiti Sains Malaysia Pusat Pengajian Sains Perubatan
institution	Universiti Sains Malaysia
collection	USM Institutional Repository
language	English
topic	R Medicine
spellingShingle	R Medicine Bolong @ Darwis, Mohammad Firdaus @ Mohd A randomized controlled trial of the effectiveness of “chest pain evaluation at emergency room” (cheer) protocol in the ed of HUSM: a model for Malaysian emergency departments
description	Background Management of low risk chest pain in adults is a problem in emergency department in Malaysia. Traditional use of CK/CKMB ratio among others has been used to manage patients presenting with low risk chest pain in Malaysia. Sometimes patients are admitted to the medical ward for observation due to the ambiguity of management of low risk chest pain thus creating overcrowding in ED or unnecessary referral and admission to the medical wards, which will occupy beds and worsen backlog of admission Methods This prospective randomised control trial included 53 patients with low risk chest pain admitted to Emergency department in Hospital USM. Patients were randomised to either a standard care arm for chest pain treatment according to current HUSM guideline or CHEER (Chest Pain Evaluation in Emergency Room) protocol arm which involves 8 hours observation with serial ECG and Troponin test. Patients information such as age, chest pain characteristics, demography, ECG findings, HEART and TIMI score were calculated during the stay. Patients were followed up after 6 weeks and 6 months to determine prevalence of Major Adverse Cardiac Event, Readmission to ED for chest pain, and their length of stay in hospital and rate of early discharge from ED. Results Study shows that CHEER protocol has overall shorter length of stay at ED or hospital and has higher early discharge rate compared to standard care. There is Background Management of low risk chest pain in adults is a problem in emergency department in Malaysia. Traditional use of CK/CKMB ratio among others has been used to manage patients presenting with low risk chest pain in Malaysia. Sometimes patients are admitted to the medical ward for observation due to the ambiguity of management of low risk chest pain thus creating overcrowding in ED or unnecessary referral and admission to the medical wards, which will occupy beds and worsen backlog of admission Methods This prospective randomised control trial included 53 patients with low risk chest pain admitted to Emergency department in Hospital USM. Patients were randomised to either a standard care arm for chest pain treatment according to current HUSM guideline or CHEER (Chest Pain Evaluation in Emergency Room) protocol arm which involves 8 hours observation with serial ECG and Troponin test. Patients information such as age, chest pain characteristics, demography, ECG findings, HEART and TIMI score were calculated during the stay. Patients were followed up after 6 weeks and 6 months to determine prevalence of Major Adverse Cardiac Event, Readmission to ED for chest pain, and their length of stay in hospital and rate of early discharge from ED. Results Study shows that CHEER protocol has overall shorter length of stay at ED or hospital and has higher early discharge rate compared to standard care. There is
format	Thesis
qualification_level	Master's degree
author	Bolong @ Darwis, Mohammad Firdaus @ Mohd
author_facet	Bolong @ Darwis, Mohammad Firdaus @ Mohd
author_sort	Bolong @ Darwis, Mohammad Firdaus @ Mohd
title	A randomized controlled trial of the effectiveness of “chest pain evaluation at emergency room” (cheer) protocol in the ed of HUSM: a model for Malaysian emergency departments
title_short	A randomized controlled trial of the effectiveness of “chest pain evaluation at emergency room” (cheer) protocol in the ed of HUSM: a model for Malaysian emergency departments
title_full	A randomized controlled trial of the effectiveness of “chest pain evaluation at emergency room” (cheer) protocol in the ed of HUSM: a model for Malaysian emergency departments
title_fullStr	A randomized controlled trial of the effectiveness of “chest pain evaluation at emergency room” (cheer) protocol in the ed of HUSM: a model for Malaysian emergency departments
title_full_unstemmed	A randomized controlled trial of the effectiveness of “chest pain evaluation at emergency room” (cheer) protocol in the ed of HUSM: a model for Malaysian emergency departments
title_sort	randomized controlled trial of the effectiveness of “chest pain evaluation at emergency room” (cheer) protocol in the ed of husm: a model for malaysian emergency departments
granting_institution	Universiti Sains Malaysia
granting_department	Pusat Pengajian Sains Perubatan
publishDate	2020
url	http://eprints.usm.my/50251/1/Muhammad%20Firdaus%20Bolong-24%20pages1.pdf
_version_	1747822029754597376

A randomized controlled trial of the effectiveness of “chest pain evaluation at emergency room” (cheer) protocol in the ed of HUSM: a model for Malaysian emergency departments

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