Summary: For patients seeking emergency care for chest pain, using an accelerated diagnostic protocol may safely identify those at sufficiently low risk of acute coronary syndrome to allow discharge without further evaluation (ie, without the traditional “serial troponins” measured over a 12-24 hour hospital observation stay). For a patient to be considered low risk on this protocol, he or she must have 1) a TIMI risk score of 0, AND 2) no new ECG changes, AND 3) normal troponin values at 0 and 2 hours after presentation.

Strength of Recommendation = B