Improving Emergency Department Management of Patients Presenting with Chest Pain

Adopting a formal protocol to quickly rule out patients without acute coronary syndrome shows some success in a New Zealand study.

The efficient triage of patients who present with chest pain to the emergency department (ED) is necessary so that clinicians can identify those with true cardiac disorders. Investigators from New Zealand conducted a trial to assess the safety and effectiveness of adopting clinical pathways for a possible acute coronary syndrome (ACS) in seven diverse hospitals.

Each hospital chose an accelerated diagnostic protocol (ADP), and most developed its own version with staff. The ADP required troponin measurement on arrival and then at 1, 2, or 3 hours in addition to electrocardiographic testing, systematized risk stratification, and methods for combining these to determine eligibility for early discharge.

There were 11,529 patients with two troponi…

Reviewing Author

Joel M. Gore, MD

Disclosures

Grant/Research SupportNIH–National Heart, Lung, and Blood Institute

Joel M. Gore, MD

Disclosures

Grant/Research SupportNIH–National Heart, Lung, and Blood Institute

Improving Emergency Department Management of Patients Presenting with Chest Pain

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Reviewing Author