Lock It In
Bottom Line
Cardiovascular prioritisation starts by identifying the patient whose brain, heart, kidneys, lungs or limbs are losing perfusion now.
Cardiovascular prioritisation starts by identifying the patient whose brain, heart, kidneys, lungs or limbs are losing perfusion now. A dramatic diagnosis is not automatically the highest priority. New ischaemia, shock, a haemodynamically significant dysrhythmia, acute pulmonary oedema, major haemorrhage, tamponade, acute aortic disease or threatened limb perfusion takes precedence over stable chronic cardiovascular disease. The advanced-practice question is: what process is threatening perfusion, what must be investigated immediately, what treatment cannot wait, and where does this patient need to go next?