Acute chest pain is a very serious emergency that threatened patient’s lives. Make a definite diagnosis as soon as possible and start certainty therapy is very critical. The main factors that delayed diagnosis and treatment of this kind of patients include insufficient cognition by oneself, time delays before visiting and diagnosis and management delayed in the hospital . And the third factor is the medical part that can be improved fast as possible.
In the past, the hospital pattern of diagnosis and treatment presented as assessment or previewing patients with acute chest pain by physicians depending on their personal medical expertise. This kind of pattern had multiple disadvantages. Firstly, medical resources could not be distributed effectively and reasonably. The amount of emergency patients in hospitals of class three grades A increased rapidly with the social development and the concept transition. Sometimes, there were too many patients lining up in apex time. Emergency doctors had no time to care for some patients who really needed diagnosis and cure in precedence. And acute chest pain is one of the preferential diseases. If these patients were passive and then too much time was lost in examination for first things first, that would cause the delay of diagnosis and cure . Secondly, triage of outpatients depended on the experience of charged nurse. Since her or different physicians’ experience and level were distinct, that would cause objective triage and incorrect evaluation. That resulted in failing to discover and diagnose some insidious fatal chest pain.
To aim directly at the above issues, we adopted two major measures to solve them. First, all the patients complained with chest pain and chest distress were admitted to rescue room for diagnosis and cure. The consummate monitor and emergency equipments ensured the compact diagnose and examination time, which should be controlled better. And the misdiagnosis rate of fatal chest pain was thus decreased . Second, the procedure of diagnosis and cure was carrying out according to the acute chest pain screening flow-process diagram. This procedure avoided the experience and level difference between doctors, and the misdiagnosis rate of fatal chest pain was reduced. Through the practice of the two measures, we found the misdiagnosis rate of fatal chest pain was decreased, and the definite time to diagnosis was shortened obviously. We believe that the definite time to diagnosis is more important in rescue the patient’s life. Earlier period diagnosis and definitive treatment can improve the prognosis and reduce the complication apparently, and also lessen the patients’ economic burden of continued treatment. We compared the probably increase of patients in rescue room and the probably increase of medical cost. We found that the passage was not blocked because of the reasonable evaluation procedure, although the patients were increased. The mean residence time in rescue room was no more than half an hour. In addition, it was true that the medical costs of all the patients with chest pain were increased slightly before definite diagnosis, but it was not increased obviously compared with the annum emergency cost of all the patients. Consideration of the benefit of continued cost decrease brought by early diagnosis and improvement of prognosis, the slightly increase of the emergency expenses is acceptable.
To sum up, we think it is important to start the rescue procedure of acute chest pain when patients complain of high-risk symptoms. And the acute chest pain screening flow-process diagram should be followed in diagnosing and rescuing patients in rescue room.