Abstract
ObjectiveTo explore the diagnostic procedure of acute fatal chest pain in emergency department (ED) in order to decrease the misdiagnosis rate and shorten the definite time to diagnosis. The ultimate aim is to rescue the patients timely and effectively.MethodsThree hundreds and two patients (56.9±11.8 Years, 72% men) complained with acute chest pain and chest distress presenting to our ED were recruited. They were divided into two groups according to visiting time (Group I: from October 2010 to March 2011, Group II: from October 2011 to March 2012). The misdiagnosis rate, definite time for diagnosis and medical expense were analyzed. Patients of Group I were diagnosed by initial doctors who made their diagnosis according to personal experience in outpatient service or rescue room in ED. While patients of Group II were all admitted to rescue room and were diagnosed and rescued according to the acute chest pain screening flow-process diagram. Differences inter-group was compared.ResultsThe misdiagnosis rate of fatal chest pain in Group I and Group II was 6.8% and 0% respectively, and there was statistic difference (P=0.000). The definite time to diagnosis was 65.3 min and 40.1 min in control and Group II respectively, the difference had statistic significance (P=0.000). And the mean cost for treatment was 787.5/124.5 ¥/$ and 905.5/143.2 ¥/$ respectively, and there was statistic difference too (P=0.012).ConclusionTreating emergency patients with acute chest pain according to the acute chest pain screening flow-process diagram in rescue room will decrease misdiagnosis apparently, and it can also shorten the definite time to correct diagnosis. It has a remarkable positive role in rescuing patients with acute chest pain timely and effectively.
Highlights
Chest pain is a common urgent condition in emergency department (ED)
The patients visiting from October 2010 to March 2011 were enrolled in groups according to visiting time (Group I), and Group II included patients visiting from October 2011 to March
While patients of Group II were all enrolled in rescue room and were diagnosed and rescued according to the acute chest pain screening flowprocess diagram (Figure 1)
Summary
Chest pain is a common urgent condition in emergency department (ED). Fatal chest pain is a more serious condition threatening the lives of patients and security of medical treatment. The definite time to correct diagnosis of fatal chest pain is an important factor for treatment and prognosis [1]. Phenomena with misdiagnosis or too long time to definite diagnosis of fatal chest pain could often be seen, and the appropriate treatment was delayed. How to decrease the misdiagnosis rate and shorten the definite time to diagnosis is a challenge for emergency doctors and those who must face it. We rescued patients with acute chest pain in standardization according to acute chest pain screening flow-process diagram and acquired satisfactory results
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