Added Mar 3 2026 QI Image.drawio
This commit is contained in:
Daniel Onyejesi
parent
476b79c417
commit
02e85a3d43
1 changed files with 171 additions and 0 deletions
171
Mar 3 2026 QI Image.drawio
Normal file
171
Mar 3 2026 QI Image.drawio
Normal file
|
|
@ -0,0 +1,171 @@
|
|||
<mxfile host="app.diagrams.net" agent="Mozilla/5.0 (X11; Linux x86_64; rv:147.0) Gecko/20100101 Firefox/147.0" version="29.6.0">
|
||||
<diagram name="CXR QI Flowchart" id="9AojJ5SYZ3YuZ7WpwGyt">
|
||||
<mxGraphModel dx="1426" dy="765" grid="1" gridSize="10" guides="1" tooltips="1" connect="1" arrows="1" fold="1" page="1" pageScale="1" pageWidth="850" pageHeight="1100" math="0" shadow="0">
|
||||
<root>
|
||||
<mxCell id="0" />
|
||||
<mxCell id="1" parent="0" />
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-1" parent="1" style="text;html=1;align=center;verticalAlign=middle;resizable=0;points=[];autosize=1;strokeColor=none;fillColor=none;" value="<b style="font-size:15px;letter-spacing:1px;">QI TO DECREASE UNNECESSARY CHEST X-RAY<br>IN ACUTE ASTHMA EXACERBATION IN CHILDREN 2–18 YEARS</b>" vertex="1">
|
||||
<mxGeometry height="50" width="700" x="315" y="40" as="geometry" />
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-2" parent="1" style="rounded=1;whiteSpace=wrap;html=1;fillColor=#dae8fc;strokeColor=#6c8ebf;strokeWidth=2;arcSize=12;verticalAlign=top;align=left;shadow=1;" value="<div style="text-align:left;padding:10px;"><b style="font-size:12px;">INCLUSION CRITERIA</b><br><br>• Children age 2–18 years<br>• Established asthma diagnosis<br>• Presentation consistent with acute asthma exacerbation</div>" vertex="1">
|
||||
<mxGeometry height="130" width="330" x="130" y="120" as="geometry" />
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-3" parent="1" style="rounded=1;whiteSpace=wrap;html=1;fillColor=#f8cecc;strokeColor=#b85450;strokeWidth=2;arcSize=8;verticalAlign=top;align=left;shadow=1;" value="" vertex="1">
|
||||
<mxGeometry height="310" width="530" x="520" y="120" as="geometry" />
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-4" parent="1" style="text;html=1;align=left;verticalAlign=top;resizable=0;points=[];autosize=0;strokeColor=none;fillColor=none;" value="<div style="text-align:left;padding:10px 10px 4px 10px;"><b style="font-size:12px;">EXCLUSION CRITERIA</b><br><br>• Comorbidities: sickle cell disease, congenital heart disease,<br> immunodeficiency, BPD, severe malnutrition<br>• First-time wheezing unrelated to prior asthma diagnosis</div>" vertex="1">
|
||||
<mxGeometry height="105" width="510" x="530" y="125" as="geometry" />
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-5" parent="1" style="line;strokeWidth=1;strokeColor=#b85450;dashed=1;dashPattern=5 3;html=1;" value="" vertex="1">
|
||||
<mxGeometry height="1" width="490" x="540" y="235" as="geometry" />
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-6" parent="1" style="rounded=1;whiteSpace=wrap;html=1;fillColor=#f5e6e6;strokeColor=#d4a0a0;strokeWidth=1;arcSize=10;verticalAlign=top;align=left;shadow=0;dashed=1;dashPattern=4 4;" value="<div style="text-align:left;padding:8px 10px;"><b style="font-size:11px;color:#b85450;">⚑ Other conditions where CXR is required:</b><br><br><table style="font-size:11px;border-collapse:collapse;width:100%;"><tr><td style="padding:3px 8px;vertical-align:top;">•</td><td style="padding:3px 0;">Physical findings suggestive of <b>pneumonia or parenchymal disease</b><br><span style="color:#666;">(focal crackles, dullness, fever)</span></td></tr><tr><td style="padding:3px 8px;vertical-align:top;">•</td><td style="padding:3px 0;">Suspicion of <b>inhaled foreign body</b><br><span style="color:#666;">(sudden onset, unilateral decreased breath sounds)</span></td></tr><tr><td style="padding:3px 8px;vertical-align:top;">•</td><td style="padding:3px 0;">Suspicion of <b>structural complications</b><br><span style="color:#666;">(pneumothorax, pneumomediastinum)</span></td></tr><tr><td style="padding:3px 8px;vertical-align:top;">•</td><td style="padding:3px 0;"><b>Trauma, post-op</b></td></tr></table></div>" vertex="1">
|
||||
<mxGeometry height="175" width="505" x="535" y="245" as="geometry" />
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-7" edge="1" parent="1" style="endArrow=none;html=1;strokeWidth=2;strokeColor=#888888;" value="">
|
||||
<mxGeometry relative="1" as="geometry">
|
||||
<mxPoint x="295" y="250" as="sourcePoint" />
|
||||
<mxPoint x="295" y="460" as="targetPoint" />
|
||||
</mxGeometry>
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-8" edge="1" parent="1" style="endArrow=none;html=1;strokeWidth=2;strokeColor=#888888;" value="">
|
||||
<mxGeometry relative="1" as="geometry">
|
||||
<mxPoint x="295" y="460" as="sourcePoint" />
|
||||
<mxPoint x="785" y="460" as="targetPoint" />
|
||||
</mxGeometry>
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-9" edge="1" parent="1" style="endArrow=none;html=1;strokeWidth=2;strokeColor=#888888;" value="">
|
||||
<mxGeometry relative="1" as="geometry">
|
||||
<mxPoint x="785" y="430" as="sourcePoint" />
|
||||
<mxPoint x="785" y="460" as="targetPoint" />
|
||||
</mxGeometry>
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-10" edge="1" parent="1" style="endArrow=classic;endSize=8;html=1;strokeWidth=2;strokeColor=#888888;" value="">
|
||||
<mxGeometry relative="1" as="geometry">
|
||||
<mxPoint x="540" y="460" as="sourcePoint" />
|
||||
<mxPoint x="540" y="500" as="targetPoint" />
|
||||
</mxGeometry>
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-11" parent="1" style="rounded=1;whiteSpace=wrap;html=1;fillColor=#d5e8d4;strokeColor=#82b366;strokeWidth=2;arcSize=20;shadow=1;" value="<b style="font-size:13px;">DO NOT ROUTINELY OBTAIN CHEST X-RAY</b><br><i>in typical / uncomplicated asthma exacerbation</i>" vertex="1">
|
||||
<mxGeometry height="65" width="440" x="320" y="500" as="geometry" />
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-12" edge="1" parent="1" source="pRgEexwxrKvvUqylI0am-11" style="endArrow=classic;endSize=8;html=1;strokeWidth=2;strokeColor=#888888;exitX=0.5;exitY=1;exitDx=0;exitDy=0;entryX=0.5;entryY=0;entryDx=0;entryDy=0;" target="pRgEexwxrKvvUqylI0am-13" value="">
|
||||
<mxGeometry relative="1" as="geometry" />
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-13" parent="1" style="rounded=1;whiteSpace=wrap;html=1;fillColor=#fff2cc;strokeColor=#d6b656;strokeWidth=2;arcSize=20;shadow=1;" value="<b style="font-size:13px;">CONSIDER OBTAINING CXR IF:</b>" vertex="1">
|
||||
<mxGeometry height="55" width="350" x="370" y="605" as="geometry" />
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-14" parent="1" style="text;html=1;align=center;verticalAlign=middle;resizable=0;points=[];autosize=1;strokeColor=none;fillColor=none;" value="<b style="font-size:18px;color:#cc0000;">OR</b>" vertex="1">
|
||||
<mxGeometry height="40" width="50" x="520" y="685" as="geometry" />
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-15" edge="1" parent="1" style="endArrow=none;html=1;strokeWidth=2;strokeColor=#cc0000;" value="">
|
||||
<mxGeometry relative="1" as="geometry">
|
||||
<mxPoint x="370" y="632" as="sourcePoint" />
|
||||
<mxPoint x="285" y="632" as="targetPoint" />
|
||||
</mxGeometry>
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-16" edge="1" parent="1" style="endArrow=classic;endSize=8;html=1;strokeWidth=2;strokeColor=#cc0000;" value="">
|
||||
<mxGeometry relative="1" as="geometry">
|
||||
<mxPoint x="285" y="632" as="sourcePoint" />
|
||||
<mxPoint x="285" y="730" as="targetPoint" />
|
||||
</mxGeometry>
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-17" parent="1" style="rounded=1;whiteSpace=wrap;html=1;fillColor=#f8cecc;strokeColor=#b85450;strokeWidth=2;arcSize=15;shadow=1;" value="<b style="font-size:12px;">Severe Respiratory Distress<br>Respiratory Score 7–12</b>" vertex="1">
|
||||
<mxGeometry height="80" width="270" x="150" y="730" as="geometry" />
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-18" edge="1" parent="1" style="endArrow=none;html=1;strokeWidth=2;strokeColor=#4472C4;" value="">
|
||||
<mxGeometry relative="1" as="geometry">
|
||||
<mxPoint x="720" y="632" as="sourcePoint" />
|
||||
<mxPoint x="820" y="632" as="targetPoint" />
|
||||
</mxGeometry>
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-19" edge="1" parent="1" style="endArrow=classic;endSize=8;html=1;strokeWidth=2;strokeColor=#4472C4;" value="">
|
||||
<mxGeometry relative="1" as="geometry">
|
||||
<mxPoint x="820" y="632" as="sourcePoint" />
|
||||
<mxPoint x="820" y="730" as="targetPoint" />
|
||||
</mxGeometry>
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-20" parent="1" style="rounded=1;whiteSpace=wrap;html=1;fillColor=#f8cecc;strokeColor=#b85450;strokeWidth=2;arcSize=15;shadow=1;" value="<b style="font-size:12px;">Inadequate Response After ≥ 2 Hours<br>of Routine Asthma Exacerbation Management</b><br><i>WITH any of the following:</i>" vertex="1">
|
||||
<mxGeometry height="90" width="400" x="620" y="730" as="geometry" />
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-21" edge="1" parent="1" source="pRgEexwxrKvvUqylI0am-20" style="endArrow=classic;endSize=8;html=1;strokeWidth=2;strokeColor=#4472C4;exitX=0.5;exitY=1;exitDx=0;exitDy=0;" value="">
|
||||
<mxGeometry relative="1" as="geometry">
|
||||
<mxPoint x="820" y="860" as="targetPoint" />
|
||||
</mxGeometry>
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-22" parent="1" style="shape=partialRectangle;whiteSpace=wrap;html=1;fillColor=#dae8fc;strokeColor=#6c8ebf;strokeWidth=1.5;top=1;left=1;bottom=1;right=1;align=center;verticalAlign=middle;fontSize=11;" value="<b>Past Medical<br>History</b>" vertex="1">
|
||||
<mxGeometry height="55" width="160" x="550" y="870" as="geometry" />
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-23" parent="1" style="shape=partialRectangle;whiteSpace=wrap;html=1;fillColor=#FFFFFF;strokeColor=#6c8ebf;strokeWidth=1.5;top=1;left=0;bottom=1;right=1;align=left;verticalAlign=middle;fontSize=11;" value="<div style="padding-left:12px;">1. History of recurrent pneumonia<br>2. History of pneumothorax</div>" vertex="1">
|
||||
<mxGeometry height="55" width="340" x="710" y="870" as="geometry" />
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-24" parent="1" style="shape=partialRectangle;whiteSpace=wrap;html=1;fillColor=#dae8fc;strokeColor=#6c8ebf;strokeWidth=1.5;top=0;left=1;bottom=1;right=1;align=center;verticalAlign=middle;fontSize=11;" value="<b>RR &gt; 40*</b>" vertex="1">
|
||||
<mxGeometry height="40" width="160" x="550" y="925" as="geometry" />
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-25" parent="1" style="shape=partialRectangle;whiteSpace=wrap;html=1;fillColor=#FFFFFF;strokeColor=#6c8ebf;strokeWidth=1.5;top=0;left=0;bottom=1;right=1;align=center;verticalAlign=middle;fontSize=11;" value="2–5 years of age" vertex="1">
|
||||
<mxGeometry height="40" width="340" x="710" y="925" as="geometry" />
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-26" parent="1" style="shape=partialRectangle;whiteSpace=wrap;html=1;fillColor=#dae8fc;strokeColor=#6c8ebf;strokeWidth=1.5;top=0;left=1;bottom=1;right=1;align=center;verticalAlign=middle;fontSize=11;" value="<b>RR &gt; 30*</b>" vertex="1">
|
||||
<mxGeometry height="40" width="160" x="550" y="965" as="geometry" />
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-27" parent="1" style="shape=partialRectangle;whiteSpace=wrap;html=1;fillColor=#FFFFFF;strokeColor=#6c8ebf;strokeWidth=1.5;top=0;left=0;bottom=1;right=1;align=center;verticalAlign=middle;fontSize=11;" value="6–8 years of age" vertex="1">
|
||||
<mxGeometry height="40" width="340" x="710" y="965" as="geometry" />
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-28" parent="1" style="shape=partialRectangle;whiteSpace=wrap;html=1;fillColor=#dae8fc;strokeColor=#6c8ebf;strokeWidth=1.5;top=0;left=1;bottom=1;right=1;align=center;verticalAlign=middle;fontSize=11;" value="<b>RR &gt; 20*</b>" vertex="1">
|
||||
<mxGeometry height="40" width="160" x="550" y="1005" as="geometry" />
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-29" parent="1" style="shape=partialRectangle;whiteSpace=wrap;html=1;fillColor=#FFFFFF;strokeColor=#6c8ebf;strokeWidth=1.5;top=0;left=0;bottom=1;right=1;align=center;verticalAlign=middle;fontSize=11;" value="9–18 years of age" vertex="1">
|
||||
<mxGeometry height="40" width="340" x="710" y="1005" as="geometry" />
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-30" parent="1" style="shape=partialRectangle;whiteSpace=wrap;html=1;fillColor=#dae8fc;strokeColor=#6c8ebf;strokeWidth=1.5;top=0;left=1;bottom=1;right=1;align=center;verticalAlign=middle;fontSize=11;" value="<b>Pulse Oximetry</b>" vertex="1">
|
||||
<mxGeometry height="75" width="160" x="550" y="1045" as="geometry" />
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-31" parent="1" style="shape=partialRectangle;whiteSpace=wrap;html=1;fillColor=#FFFFFF;strokeColor=#6c8ebf;strokeWidth=1.5;top=0;left=0;bottom=1;right=1;align=left;verticalAlign=middle;" value="<div style="text-align:left;padding-left:12px;font-size:11px;">Lowest SpO₂ &lt;91% on room air*<br><b>OR</b> required inhaled FiO₂ &gt;50% to keep saturations &gt;90%<br><i style="color:#888;">* after 2 hours of routine management</i></div>" vertex="1">
|
||||
<mxGeometry height="75" width="340" x="710" y="1045" as="geometry" />
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-32" parent="1" style="shape=partialRectangle;whiteSpace=wrap;html=1;fillColor=#dae8fc;strokeColor=#6c8ebf;strokeWidth=1.5;top=0;left=1;bottom=1;right=1;align=center;verticalAlign=middle;fontSize=11;" value="<b>Lung Exam</b>" vertex="1">
|
||||
<mxGeometry height="45" width="160" x="550" y="1120" as="geometry" />
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-33" parent="1" style="shape=partialRectangle;whiteSpace=wrap;html=1;fillColor=#FFFFFF;strokeColor=#6c8ebf;strokeWidth=1.5;top=0;left=0;bottom=1;right=1;align=center;verticalAlign=middle;fontSize=11;" value="Localizing findings or asymmetry on lung examination" vertex="1">
|
||||
<mxGeometry height="45" width="340" x="710" y="1120" as="geometry" />
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-34" edge="1" parent="1" style="endArrow=none;html=1;strokeWidth=2;strokeColor=#cc0000;" value="">
|
||||
<mxGeometry relative="1" as="geometry">
|
||||
<mxPoint x="285" y="810" as="sourcePoint" />
|
||||
<mxPoint x="285" y="1240" as="targetPoint" />
|
||||
</mxGeometry>
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-35" edge="1" parent="1" style="endArrow=none;html=1;strokeWidth=2;strokeColor=#cc0000;" value="">
|
||||
<mxGeometry relative="1" as="geometry">
|
||||
<mxPoint x="285" y="1240" as="sourcePoint" />
|
||||
<mxPoint x="540" y="1240" as="targetPoint" />
|
||||
</mxGeometry>
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-36" edge="1" parent="1" style="endArrow=none;html=1;strokeWidth=2;strokeColor=#4472C4;" value="">
|
||||
<mxGeometry relative="1" as="geometry">
|
||||
<mxPoint x="820" y="1165" as="sourcePoint" />
|
||||
<mxPoint x="820" y="1240" as="targetPoint" />
|
||||
</mxGeometry>
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-37" edge="1" parent="1" style="endArrow=none;html=1;strokeWidth=2;strokeColor=#4472C4;" value="">
|
||||
<mxGeometry relative="1" as="geometry">
|
||||
<mxPoint x="820" y="1240" as="sourcePoint" />
|
||||
<mxPoint x="540" y="1240" as="targetPoint" />
|
||||
</mxGeometry>
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-38" edge="1" parent="1" style="endArrow=classic;endSize=10;html=1;strokeWidth=2;strokeColor=#333333;" value="">
|
||||
<mxGeometry relative="1" as="geometry">
|
||||
<mxPoint x="540" y="1240" as="sourcePoint" />
|
||||
<mxPoint x="540" y="1280" as="targetPoint" />
|
||||
</mxGeometry>
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-39" parent="1" style="rounded=1;whiteSpace=wrap;html=1;fillColor=#d5e8d4;strokeColor=#82b366;strokeWidth=2;arcSize=20;shadow=1;" value="<b style="font-size:14px;">→ OBTAIN CHEST X-RAY</b>" vertex="1">
|
||||
<mxGeometry height="55" width="400" x="340" y="1280" as="geometry" />
|
||||
</mxCell>
|
||||
<mxCell id="pRgEexwxrKvvUqylI0am-40" parent="1" style="text;html=1;align=center;verticalAlign=middle;resizable=0;points=[];autosize=1;strokeColor=none;fillColor=none;" value="<i style="font-size:10px;color:#666666;">* Respiratory rate thresholds apply after ≥ 2 hours of routine asthma exacerbation management</i>" vertex="1">
|
||||
<mxGeometry height="30" width="520" x="310" y="1350" as="geometry" />
|
||||
</mxCell>
|
||||
</root>
|
||||
</mxGraphModel>
|
||||
</diagram>
|
||||
</mxfile>
|
||||
Loading…
Reference in a new issue