The Real Physician's creed (not the one taught by Hippocrates and adjusted by science for modern medical professionals, but the one taught only to medical students and kept hidden from nurses and especially RTs) has been updated to account for ER EKGs.
From now on, all of the following should be treated as cardiac in origin and should be indications for STAT or ASAP EKG
The obvious: chest pain, arm pain, jaw pain, nausea, vomiting, dizzy, syncopal episode, light headed, cardiac history, palpitations, electrolyte abnormalities
Could be: fell, stroke, trauma, malaise, vomiting, poverty, homeless, maggots on body, PE, COPD, bloody nose, headache, mental changes, diarrhea
The one's RTs will cringe about but we know are needed: Hang nail, bloody nose, lice, scabies, smelly patient, sore toe, patient stinks, bloody nose, rotten odor in room, rickets, any respiratory illness, over90, stress, anxiety, sore toe, lice, blurred vision, abscess on bottom, cirrhosis, or just because the nurse felt like it.
Note #1: All EKGs MUST be completed within ten minutes whether RT thinks they are indicated or not, and whether RT has "priority" therapies or not. Non-compliance in any way, or late EKGs, will result in a write-up.
Note #2: To allay rumors, this new policy has nothing to do with the fact the hospital is guaranteed reimbursement for all EKGs. Likewise, it has nothing to do with the fact the interpreting doctor gets paid $40 a pop for basically doing nothing (or is it $60 now?).