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WHAT IS CPOU? 
Patients with chest pain but at low risk of heart attack are managed in dedicated Chest Pain Observation Unit (CPOU) for up to 6 hours in Apollo Accident & Emergency Centre. CPOU aims to accelerate the care of low-risk patients and quickly identify those who need additional or extensive cardiology evaluation within a period of up to 6 hours. After 6 hours, the patient is either admitted in the hospital with identified specific problems or he is safely discharged with follow up advice and medication. CPOU, hence, ensures enhanced patient satisfaction with right management approach for his chest pain aiming for better outcome with greater accuracy in ruling out heart attack.
APOLLO CPOU PACKAGE
Price: Taka 10,000 (17 % discounted from regular tariff)
- Emergency Bed Charges – 6 hours
- Doctor Visit for ER Consultant / Cardiology / Other NCP’s Fees
- ECG – 3 times
- Chest X-ray (P/A View)
- Troponin I (serum) – 2 times
- CBC
- Glucose – Random
- Serum Urea
- Serum Creatinine
- Serum Electrolytes (Na, K, Cl, HCO3)
WHO NEEDS OBSERVATION UNDER CPOU?
The number of patients attending Emergency Department with chest pain is on the rise; however, not all of these patients have heart problems. Some of these patients can be diagnosed within 10-15 minutes as suffering from a heart problem and some can be declared free from acute heart problem within minutes. But there is a group of patients who cannot be confidently declared free from acute heart problem initially. Thus, to avoid wrong discharge or unnecessary admissions, the latter group of patients are observed in CPOU (under Emergency Department) for at least 6 hours with close monitoring, serial ECGs and a blood test on two blood samples taken at two different times.
IMPORTANCE OF CPOU
Many chest pain patients present with symptoms which are not very classical. In a lot of cases, the initial ECG may be normal and the initial blood test which helps in diagnosing an acute heart problem may be normal as well, making a diagnosis difficult. This may prompt an increased number of patient admissions with chest pain, but ultimately, majority of these may prove to have no acute heart problem. At the same time there is a risk of discharging some patients wrongly who might have shown cle ar signs of heart disease, changes in the repeat ECG after an interval and a positive blood result in the second blood sample.
The idea of CPOU under Emergency Department is to keep these patients for longer period under close observation without admitting them to CCU; serial ECG and repeat blood test after a fixed interval will be done for helping the attending doctor to make a confident decision either for discharge or admission in cases where it was difficult to diagnose initially. It will help avoid unnecessary admissions and minimize wrong discharges.
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A patient getting an ECG |
BENEFITS OF CPOU FOR PATIENTS
Studies have found that Chest Pain Observation Units improve the quality of care for patients, provide a more efficient evaluation and move patients through the Emergency Department with more confidence. Physicians’ instructions for patients in CPOU are fast-tracked, initiated within 30 minutes and the patients are given priority in testing areas such as in nuclear medicine, which is used to diagnose heart disease. CPOU has also been shown to reduce unnecessary hospital admissions and be more cost effective for patients.
DISCHARGE FROM CPOU
Patients will not be discharged from the unit until the chest pain has been resolved; their vital signs are stable and have returned to baseline; their serial cardiac enzymes and other tests are negative for heart attack. After up to 6 hours of observation in CPOU, patients will either be discharged or admitted as in-patients. Patients discharged from CPOU are arranged to have follow-up appointment with a Cardiologist or other relevant Consultants (in case of non-cardiac chest pain) within 48 hours.
Chest Pain Observation Unit (CPOU) allows improvement of quality and efficiency of care for patients with chest pains, who are at low risk for a heart attack. Apollo Hospitals Dhaka prides itself on being a cutting-edge heart care facility. Our CPOU allows us to continue providing excellent care in the specialized environment these patients need.
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