Pre-Operative ECG Prior to Internal Medicine Consult

Medical Directive ID: 
Lead Contact Person: 
Karen Rogers, Nurse Educator, Ambulatory Services
Physician/Nurse Lead: 
Dr. Kathryn Myers, Division Chief, General Internal Medicine, Division Chief, General Internal Medicine
Pre-surgical Screening Unit
Approval By: 
Medical Advisory Committee
Original Effective Date: 
Wednesday, December 9, 2015
Revised Date: 
Wednesday, January 9, 2019
To Be Reviewed Date: 
Sunday, January 9, 2022
This Medical Directive Applies to the following sites: 
St. Joseph’s
This Medical Directive Applies to the following patient population: 

Electrocardiogram (ECG)

•The Pre-Surgical Screening Unit triage nurse is to order an ECG for arrhythmia assessment for any patient that has an internal medicine consult if they have any of the following conditions identified on the patient questionnaire:

•Ischemic heart disease (e.g prior MI, angina, bypass surgery)

•Cerebrovascular disease (e.g. prior stroke or TIA)

•Peripheral arterial disease

•Diabetics on insulin if over age 30

•Known arrhythmias (or if HR greater than 100 or less than 50)

Click the link to view the entire medical directive in detail: 


SurnameKnown ByDate Signed
GilbertKennethMar 1 2019 12:29:10:270PM
LarocqueBrianMar 3 2020 07:50:31:907AM
SalimHatemMar 1 2019 12:46:38:537AM
SunDongmeiMar 13 2019 09:49:14:133PM