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Cardiac Direct Access is a program that provides same-day assessment and
treatment for patients with cardiac symptoms that are non-life threatening
but require prompt attention. Patients must be referred by a physician’s
office. You can speak directly with the cardiologist on duty and initiate
your referral by calling 617-632-7777.
The unit is staffed by experienced clinicians dedicated solely to cardiac
care. The facility includes patient exam rooms, overnight observation
rooms, testing equipment, a telemedicine facility and an outpatient
Patients with volume overload who do not have unstable vital signs or
significant hypoxia (more than 2-3L Nasal cannula requirement)
Patients with concern for malignant syncope
Patients with angina chest pain who you feel need a rule-out and urgent
stress test. (Please note: Patients with ST elevations or unstable
vital signs should go to the emergency room.)
Patients with rapid, symptomatic atrial fibrillation
Decisions about admission to the inpatient floor will be made in the
Cardiac Direct Access Unit and do not require involvement of the emergency
room. Treatment and workup started in the Cardiac Direct Access Unit will
transfer seamlessly to our inpatient service.
Patients you deem appropriate for ambulance transport with Advanced Life
Support from of your office should still be referred to the emergency room.
The Cardiac Direct Access Unit provides referring physicians with the
ability to bypass the emergency room and arrange referrals for patients
with concerning cardiac symptoms to be seen the same day by a cardiologist.
The unit is open 24 hours a day, Monday through Friday. It is staffed from
8 a.m. - 11 p.m. by an attending cardiologist and at all times by
experienced advanced practice providers and clinical nurses. This expertise
and the capacity for overnight observation mean fewer preventable hospital
Patients are seen immediately with no wait or lengthy triage process.
Extended hours for testing and consultation allow our call center to
accommodate all urgent (more than 48 hour) consult requests either in our
Shapiro 7 Cardiovascular Clinic or in the Cardiac Direct Access Unit.
Call the attending cardiologist at 617-632-7777. If the
attending is with a patient and unable to answer, you will be routed to the
unit coordinator, who will enter the consult referral into our expect
system and leave your contact number for the attending cardiologist to call
back as needed. You will always receive a call back after your patient is
evaluated to review the initial impression and plan.
Patients typically arrive by car. The Cardiac Direct Access Unit is located
on the first floor of the Deaconess Building, accessible through the Farr
Complex lobby on BIDMC’s West Campus at 185 Pilgrim Road. The closest
parking is in the BIDMC garage on Pilgrim Road. Valet parking is available
in front of the Rosenberg Clinical Center. From there patients will be
directed to the Cardiac Direct Access Unit.
During regular daytime hours, patients may walk into the Farr Lobby and ask
the ambassador to call the unit or provide an escort.
After 8 p.m, the Farr building is locked and patients will call the Cardiac
Direct Access unit from a call monitor located to the right of the main
Farr Building door. The call monitor is clearly marked “Cardiac Direct
Access.” A unit staffer will meet the patient at the door and accompany him
or her to the unit.
Same-day evaluation by a cardiologist, including evening evaluations,
overnight observation, in-unit testing (labs, echocardiography and stress),
direct transfers to the inpatient cardiology service as needed, diuresis
(scheduled and urgent) and telemedicine consultations.
Cardiac Direct Access care is similar to urgent care except that it is
dedicated to cardiac cases and patients must have a referral from their
physicians. This policy is designed to assure that patients with unstable
vital signs or evidence of acute myocardial infarction go to the emergency
room and that those at low and intermediate risk benefit from Cardiac
Direct Access care.
Call the attending cardiologist on duty at 617-632-7777.
The attending will work with you to arrange a call into our virtual meeting
room. Our software allows desktop computers, iPhones and Androids to be
used for the teleconference.
In the event that a patient experiences a sudden event or becomes unstable,
Cardiac Direct Access staff will arrange immediate transport to BIDMC's
emergency room. The patient will bypass triage and care will be provided