Added demo2 march 3 2026 qi image.drawio
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Daniel Onyejesi
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1 changed files with 137 additions and 0 deletions
137
demo2 march 3 2026 qi image.drawio
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137
demo2 march 3 2026 qi image.drawio
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<mxfile host="app.diagrams.net" agent="Mozilla/5.0 (X11; Linux x86_64; rv:147.0) Gecko/20100101 Firefox/147.0" version="29.5.5">
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<diagram name="CXR QI Flowchart" id="FjCL9AJM0kOdwFPofPE3">
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<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">
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<mxCell id="ysVk-s7ko_iClBrcKvoG-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:14px;">QI TO DECREASE UNNECESSARY CHEST X-RAY<br>IN ACUTE ASTHMA EXACERBATION IN CHILDREN 2–18 YEARS</b>" vertex="1">
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<mxGeometry height="50" width="700" x="260" y="50" as="geometry" />
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<mxCell id="ysVk-s7ko_iClBrcKvoG-2" parent="1" style="rounded=1;whiteSpace=wrap;html=1;fillColor=#dae8fc;strokeColor=#6c8ebf;arcSize=10;verticalAlign=top;align=left;" value="<div style="text-align:left;padding:8px;"><b>INCLUSION CRITERIA</b><br><br>• Children age 2–18 years<br>• Established asthma diagnosis<br>• Presentation consistent with acute asthma exacerbation</div>" vertex="1">
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<mxCell id="ysVk-s7ko_iClBrcKvoG-3" parent="1" style="rounded=1;whiteSpace=wrap;html=1;fillColor=#f8cecc;strokeColor=#b85450;arcSize=10;verticalAlign=top;align=left;" value="<div style="text-align:left;padding:8px;"><b>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<br>• Other conditions where CXR is required:<br> – Physical findings suggestive of pneumonia or parenchymal<br> disease (focal crackles, dullness, fever)<br> – Suspicion of inhaled foreign body (sudden onset,<br> unilateral decreased breath sounds)<br> – Suspicion of structural complications<br> (pneumothorax, pneumomediastinum)<br> – Trauma, post-op</div>" vertex="1">
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<mxCell id="ysVk-s7ko_iClBrcKvoG-6" edge="1" parent="1" style="endArrow=classic;html=1;" value="">
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<mxCell id="ysVk-s7ko_iClBrcKvoG-7" parent="1" style="rounded=1;whiteSpace=wrap;html=1;fillColor=#d5e8d4;strokeColor=#82b366;arcSize=20;" value="<b style="font-size:12px;">DO NOT ROUTINELY OBTAIN CHEST X-RAY</b><br><i>in typical / uncomplicated asthma exacerbation</i>" vertex="1">
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<mxCell id="ysVk-s7ko_iClBrcKvoG-8" edge="1" parent="1" source="ysVk-s7ko_iClBrcKvoG-7" style="endArrow=classic;html=1;exitX=0.5;exitY=1;exitDx=0;exitDy=0;entryX=0.5;entryY=0;entryDx=0;entryDy=0;" target="ysVk-s7ko_iClBrcKvoG-9" value="">
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<mxCell id="ysVk-s7ko_iClBrcKvoG-9" parent="1" style="rounded=1;whiteSpace=wrap;html=1;fillColor=#fff2cc;strokeColor=#d6b656;arcSize=20;" value="<b style="font-size:12px;">CONSIDER OBTAINING CXR IF:</b>" vertex="1">
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</mxCell>
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<mxCell id="ysVk-s7ko_iClBrcKvoG-10" parent="1" style="text;html=1;align=center;verticalAlign=middle;resizable=0;points=[];autosize=1;strokeColor=none;fillColor=none;" value="<b style="font-size:16px;color:#cc0000;">OR</b>" vertex="1">
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<mxCell id="ysVk-s7ko_iClBrcKvoG-11" edge="1" parent="1" source="ysVk-s7ko_iClBrcKvoG-9" style="endArrow=classic;html=1;exitX=0;exitY=1;exitDx=0;exitDy=0;entryX=0.5;entryY=0;entryDx=0;entryDy=0;strokeColor=#cc0000;" target="ysVk-s7ko_iClBrcKvoG-12" value="">
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<mxGeometry relative="1" as="geometry" />
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<mxCell id="ysVk-s7ko_iClBrcKvoG-12" parent="1" style="rounded=1;whiteSpace=wrap;html=1;fillColor=#f8cecc;strokeColor=#b85450;arcSize=15;" value="<b style="font-size:11px;">Severe Respiratory Distress<br>Respiratory Score 7–12</b>" vertex="1">
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<mxGeometry height="80" width="250" x="110" y="610" as="geometry" />
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</mxCell>
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<mxCell id="ysVk-s7ko_iClBrcKvoG-13" edge="1" parent="1" source="ysVk-s7ko_iClBrcKvoG-9" style="endArrow=classic;html=1;exitX=1;exitY=1;exitDx=0;exitDy=0;entryX=0.5;entryY=0;entryDx=0;entryDy=0;strokeColor=#4472C4;" target="ysVk-s7ko_iClBrcKvoG-14" value="">
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<mxGeometry relative="1" as="geometry" />
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</mxCell>
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<mxCell id="ysVk-s7ko_iClBrcKvoG-14" parent="1" style="rounded=1;whiteSpace=wrap;html=1;fillColor=#f8cecc;strokeColor=#b85450;arcSize=15;" value="<b style="font-size:11px;">Inadequate Response After ≥ 2 Hours<br>of Routine Asthma Exacerbation Management</b><br><i>WITH any of the following:</i>" vertex="1">
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<mxGeometry height="90" width="380" x="540" y="600" as="geometry" />
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<mxCell id="ysVk-s7ko_iClBrcKvoG-15" edge="1" parent="1" source="ysVk-s7ko_iClBrcKvoG-14" style="endArrow=classic;html=1;exitX=0.5;exitY=1;exitDx=0;exitDy=0;strokeColor=#4472C4;" value="">
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<mxGeometry relative="1" as="geometry">
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<mxPoint x="730" y="730" as="targetPoint" />
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</mxGeometry>
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</mxCell>
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<mxCell id="ysVk-s7ko_iClBrcKvoG-16" parent="1" style="shape=partialRectangle;whiteSpace=wrap;html=1;fillColor=#dae8fc;strokeColor=#6c8ebf;top=1;left=1;bottom=1;right=1;align=center;verticalAlign=middle;" value="<b>Past Medical<br>History</b>" vertex="1">
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<mxGeometry height="50" width="150" x="470" y="730" as="geometry" />
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</mxCell>
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<mxCell id="ysVk-s7ko_iClBrcKvoG-17" parent="1" style="shape=partialRectangle;whiteSpace=wrap;html=1;fillColor=#FFFFFF;strokeColor=#6c8ebf;top=1;left=1;bottom=1;right=1;align=left;verticalAlign=middle;spacingLeft=10;" value="1. History of recurrent pneumonia<br>2. History of pneumothorax" vertex="1">
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<mxGeometry height="50" width="350" x="620" y="730" as="geometry" />
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</mxCell>
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<mxCell id="ysVk-s7ko_iClBrcKvoG-18" parent="1" style="shape=partialRectangle;whiteSpace=wrap;html=1;fillColor=#dae8fc;strokeColor=#6c8ebf;top=1;left=1;bottom=1;right=1;align=center;verticalAlign=middle;" value="<b>RR &gt; 40*</b>" vertex="1">
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<mxGeometry height="40" width="150" x="470" y="780" as="geometry" />
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</mxCell>
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<mxCell id="ysVk-s7ko_iClBrcKvoG-19" parent="1" style="shape=partialRectangle;whiteSpace=wrap;html=1;fillColor=#FFFFFF;strokeColor=#6c8ebf;top=1;left=1;bottom=1;right=1;align=center;verticalAlign=middle;" value="2–5 years of age" vertex="1">
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<mxGeometry height="40" width="350" x="620" y="780" as="geometry" />
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</mxCell>
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<mxCell id="ysVk-s7ko_iClBrcKvoG-20" parent="1" style="shape=partialRectangle;whiteSpace=wrap;html=1;fillColor=#dae8fc;strokeColor=#6c8ebf;top=1;left=1;bottom=1;right=1;align=center;verticalAlign=middle;" value="<b>RR &gt; 30*</b>" vertex="1">
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<mxGeometry height="40" width="150" x="470" y="820" as="geometry" />
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</mxCell>
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<mxCell id="ysVk-s7ko_iClBrcKvoG-21" parent="1" style="shape=partialRectangle;whiteSpace=wrap;html=1;fillColor=#FFFFFF;strokeColor=#6c8ebf;top=1;left=1;bottom=1;right=1;align=center;verticalAlign=middle;" value="6–8 years of age" vertex="1">
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<mxGeometry height="40" width="350" x="620" y="820" as="geometry" />
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</mxCell>
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<mxCell id="ysVk-s7ko_iClBrcKvoG-22" parent="1" style="shape=partialRectangle;whiteSpace=wrap;html=1;fillColor=#dae8fc;strokeColor=#6c8ebf;top=1;left=1;bottom=1;right=1;align=center;verticalAlign=middle;" value="<b>RR &gt; 20*</b>" vertex="1">
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<mxGeometry height="40" width="150" x="470" y="860" as="geometry" />
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</mxCell>
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<mxCell id="ysVk-s7ko_iClBrcKvoG-23" parent="1" style="shape=partialRectangle;whiteSpace=wrap;html=1;fillColor=#FFFFFF;strokeColor=#6c8ebf;top=1;left=1;bottom=1;right=1;align=center;verticalAlign=middle;" value="9–18 years of age" vertex="1">
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<mxGeometry height="40" width="350" x="620" y="860" as="geometry" />
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</mxCell>
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<mxCell id="ysVk-s7ko_iClBrcKvoG-24" parent="1" style="shape=partialRectangle;whiteSpace=wrap;html=1;fillColor=#dae8fc;strokeColor=#6c8ebf;top=1;left=1;bottom=1;right=1;align=center;verticalAlign=middle;" value="<b>Pulse Oximetry</b>" vertex="1">
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<mxGeometry height="70" width="150" x="470" y="900" as="geometry" />
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</mxCell>
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<mxCell id="ysVk-s7ko_iClBrcKvoG-25" parent="1" style="shape=partialRectangle;whiteSpace=wrap;html=1;fillColor=#FFFFFF;strokeColor=#6c8ebf;top=1;left=1;bottom=1;right=1;align=left;verticalAlign=middle;" value="<div style="text-align:left;padding-left:10px;">Lowest SpO₂ &lt;91% on room air*<br><b>OR</b> required inhaled FiO₂ &gt;50% to keep saturations &gt;90%<br><i>* after 2 hours of routine management</i></div>" vertex="1">
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<mxGeometry height="70" width="350" x="620" y="900" as="geometry" />
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</mxCell>
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<mxCell id="ysVk-s7ko_iClBrcKvoG-26" parent="1" style="shape=partialRectangle;whiteSpace=wrap;html=1;fillColor=#dae8fc;strokeColor=#6c8ebf;top=1;left=1;bottom=1;right=1;align=center;verticalAlign=middle;" value="<b>Lung Exam</b>" vertex="1">
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<mxCell id="ysVk-s7ko_iClBrcKvoG-27" parent="1" style="shape=partialRectangle;whiteSpace=wrap;html=1;fillColor=#FFFFFF;strokeColor=#6c8ebf;top=1;left=1;bottom=1;right=1;align=center;verticalAlign=middle;" value="Localizing findings or asymmetry on lung examination" vertex="1">
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