ED Pathway for the Evaluation/Treatment of Chest Pain in Children without Known Cardiac Disease

Outpatient Treatment

Musculoskeletal
  • NSAIDS with adequate PO
  • Follow-up with PMD as needed
Respiratory
  • Treat asthma as indicated
  • Treat pneumonia as indicated
  • Follow-up with PMD 7 days
GI
  • Ranitidine
  • Follow-up with PMD 7-10 days
Psychological
  • Decrease stimulants, caffeine
  • Complete SW Consult to evaluate risk
  • BHS when for adolescents > 13
  • Meditation, relaxation techniques
  • Follow-up with outpatient MH as needed
  • Follow-up with PMD 7-10 days
Any Positive Risk Factors for Cardiovascular Etiology
  • Exercise Restriction: no gym, no sports, okay to walk
  • Click cardiology follow-up box in Chest pain Discharge Smart Set:
    • Within 1 week if positive history or physical exam
    • Within 2 weeks if positive past medical history or family history
  • Follow-up with PMD 7 days