Clinical Documentation Tip Sheets

CHEST PAIN Inpatient admission is indicated for 1 or more of the following: Hemodynamic instability (See General Tip Card) Chest pain indicative of serious diagnosis other than coronary artery disease (eg, aortic dissection, pulmonary embolism) Presenting signs or symptoms (eg, chest pain) persist despite observation care

CARDIAC ARRYTHMIA Inpatient admission is indicated for 1 or more of the following: Sustained VT: 30 seconds or more of ventricular rhythm >100 beats/min Ventricular escape rhythm Second- or third-degree atrioventricular block New-onset left bundle branch block with suspected myocardial ischemia Continuous ECG monitoring needed beyond observation care Defibrillator that is repeatedly firing, malfunctioning, or in need of immediate adjustment of settings beyond observation care I npatient admission is indicated for 1 or more of the following: Severe persistent pulmonary edema, anasarca or peripheral edema Increased creatinine with reduction of more than 25% in glomerular filtration rate from baseline Pulmonary artery catheter monitoring needed Cardiac Arrythmia (see arrhythmia) Dyspnea or tachypnea that persist despite observation care Hemodynamic instability (See General Tip Card) Electrolyte abnormalities (see Nephrology Tip Card) Severe persistent altered mental status (See Neuro Tip Card) HEART FAILURE

HYPOTENSION Inpatient admission is indicated for 1 or more of the following: Severe persistent hypotension, as indicated by 1 or more of the following: Lactate of 2.0 mmol/L (18 mg/dL) or more secondary to hypotension Metabolic acidosis (arterial or venous pH less than 7.35)[ not otherwise explained Mean arterial pressure less than 65 mm Hg IV inotropic or vasopressor medication