Risk Stratification for Patients with Non-ST-Segment Elevation Acute Coronary Syndromes in the Emergency Department

Emergency physicians routinely risk stratify multiple patients simultaneously in the emergency setting. Identifying the critically ill or injured patient rapidly allows for appropriate therapy to be delivered in a timely fashion. For patients with possible acute coronary syndrome, the 12-lead electrocardiogram obtained within 10 minutes after arrival to the ED quickly identifies patients with ST-segment elevation myocardial infarction (STEMI) requiring rapid reperfusion by percutaneous coronary intervention in the cardiac catheterization laboratory or the administration of fibrinolytic therapy if cardiac catheterization will be delayed. For patients with unstable angina and non-ST-segment elevation myocardial infarction (NSTEMI), other diagnostic modalities help to define the critically ill patient.