ECG for all patients in the PACU: Some say, why? i say, why not?

Abstract

Currently in many Australian hospitals, electrocardiogram (ECG) leads are removed after the operative process and, despite the machines being freely available in the Post Anaesthesia Care Unit (PACU), they are not connected to all patients. There are many evidence-based reasons why an ECG would be advantageous for perioperative patient safety, including the detection of often asymptomatic conditions such as myocardial injury after non-cardiac surgery (MINS) and new-onset atrial fibrillation, which has been shown to increase the risk of stroke. Advantages may also be seen in saving precious minutes in a cardiac arrest, and the ability for nurses to constantly observe ECG rhythms strips as a learning tool. The aim of this discussion paper is to challenge health care professionals’ thinking about the use of ECG monitoring for the entire perioperative journey and inspire readers to implement this patient safety initiative.