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October 10, 1977

Monitoring Patients With Chest Pain

JAMA. 1977;238(15):1628. doi:10.1001/jama.1977.03280160022003

To the Editor.—  The correspondence regarding cardiac monitoring in the emergency room (ER) (237:2188, 1977) prompts me to the following remarks. Many ERs throughout the country have set up what could be called "auxiliary" coronary care units (CCU) for monitoring patients with chest pain. Effectiveness of these units, as compared to that of the "main" CCU, has not been evaluated, however. A few years ago I tried to collect statistics from the ERs in this area, and no one had valid data of morbidity and ultimate outcome. It seems to me that such auxiliary CCUs are wasteful both from an economic and professional point of view. The cost of providing equipment and of training ER personnel may not be justified by the parttime usage of these expensive commodities. The ER nurse uses these skills only a fraction of her working hours; even at those times they are interfered with by