Utilizing PDSA Cycle in Implementing a Chest Pain Accelerated Diagnostic Protocol.

Context: The authors in the Emergency Department (ED) at McLaren Oakland utilized the Plan-Do-Study-Act (PDSA) model to implement, evaluate and incrementally modify a Chest Pain Accelerated Diagnostic Protocol (CPADP) using the History, EKG, Age, Risk Factors, Troponin (HEART) Score at their institution. The objective of this study was to evaluate the ability of patients who presented to the ED with chest pain and fell into the low risk category based on their HEART Score to receive adequate outpatient follow-up for their chest pain.

Methods: Modifying protocols implemented at other institutions, in 2016 the authors developed CP-ADP utilizing the HEART Score to risk-stratify patients presenting to the ED with chest pain as low, moderate or high risk for major adverse cardiac events (MACE).

Traumatic cervical spine injuries: characteristics of missed injuries.

Purpose: Computed tomographic (CT) scanning has mostly replaced x-rays as an imaging modality, but concerns exist because of excess radiation, missed injuries, and whether it is the definitive procedure for intubated patients. The purpose of this study was to characterize missed cervical spine injuries (CSIs).

Methods: All pediatric (<18) trauma patients from 2004 to 2006 were analyzed.