Keeping chest pain safe and moving

But on busy Saturdays we can hit 40+ patients in 12 hours, and chest pain still walks in without an ECG on arrival. How are you triaging and risk-stratifying fast in urgent care — ECG within 10 minutes, point-of-care troponin if you have it, or straight to EMS when the story feels wrong? I’m trying to tighten our flow without compromising safety.

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We cut “ECG within 10 minutes” to under five by parking the machine in triage and letting MAs run it on any chief complaint with the word chest — before vitals or registration — and I glance at it while they room. If it’s clean we’ll layer in HEART + POC troponin at 0/60, but if there’s pain with diaphoresis or exertional onset we go straight to EMS. Have you tried HEART in your flow yet (https://www.mdcalc.com/calc/1720/heart-score-major-cardiac-events)?

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