The New Zealand medical journal
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The majority of patients who present to the Emergency Department (ED) with chest pain, do not have Acute Coronary Syndrome (ACS). Rapid, safe discharge home for this large group is hampered by clinical uncertainty. A pragmatic Accelerated Diagnostic Pathway (ADP) used in our ED achieves this goal. AiIM: To demonstrate the safety and utility of a locally developed ADP. The primary outcome for patients who were identified as non-high risk by our ADP was death or acute myocardial infarction (AMI) at 30 days. Secondary outcomes were ED length of stay, discharge rates, provocative testing and revascularisation rates. ⋯ This ED ADP for chest pain rapidly and safely identified patients who were not at high risk of a short-term AMI or death.