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"30 moles to the nearest local cardiac catheter suite"

Wow - and you're even using SI units for distance!

-----Original Message-----
From: Reynolds Tim [mailto:[log in to unmask]]
Sent: 08 November 2002 09:35
To: [log in to unmask]
Subject: Re: troponin enquiry

If you have a troponin test that can give an instant answer that would not
delay my thrombolysis then
perhaps I would accept it. Personally, I would rather I had my ECG and
infusion instead of waiting for a blood sample to be sent to the lab...

Sadly for non-ST ACS, there is a difference between relatively rural parts
of the Midlands and central London, which sucks vast amounts of NHS funds to
fuel bloated teaching hospitals with relatively resticted local populations.
In this part of the world it is 45 mins - 2 hours depending on traffic (30
moles) to the nearest local cardiac catheter suite. Immediate
revascularisation is not available here because we don't get funded.

TIM

****************************************************************************
*********
Prof. Tim Reynolds,
Clinical Chemistry Department,
Queens Hospital,
Belvedere Rd.,
Burton-on-Trent,
STAFFORDSHIRE,
DE13 0RB,
UK.
tel: 01283 511511 ext. 4035
fax: 01283 593064
email: [log in to unmask]
alternative email for the all too frequent occasions when the NHS email
connection doesn't work:
[log in to unmask]

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-----Original Message-----
From: Paul Collinson [mailto:[log in to unmask]]
Sent: 07 November 2002 21:15
To: Reynolds Tim
Cc: [log in to unmask]
Subject: Re: troponin enquiry

In message <6EA90A4C94B2D51180E30090274643AC04AADB@QH-NT-03>, Reynolds
Tim <[log in to unmask]> writes

I recommend the ESC guidelines on non ST ACS. Revascularisation is the
optimal strategy and cTn is required

Clearly the Midlands are to be avoided if you have chest pain

>Given the NSF target that thrombolysis must be commenced within 20 minutes
>of entering A&E, troponin has no role whatsoever in the urgent decision
>making process. It therefore can be evaluated at leisure the next morning
on
>the post-take ward round so does not ned to be a 24/7 test.
>
>TIM
>
>***************************************************************************
*
>*********
>Prof. Tim Reynolds,
>Clinical Chemistry Department,
>Queens Hospital,
>Belvedere Rd.,
>Burton-on-Trent,
>STAFFORDSHIRE,
>DE13 0RB,
>UK.
>tel: 01283 511511 ext. 4035
>fax: 01283 593064
>email: [log in to unmask]
>alternative email for the all too frequent occasions when the NHS email
>connection doesn't work:
>[log in to unmask]
>
>***************************************************************************
*
>**********
>IMPORTANT: This email is intended for the use of the individual
>addressee(s)named above and may contain information that is confidential
>privileged or unsuitable for overly sensitive persons with low self-esteem,
>no sense of humour or irrational religious beliefs. If you are not the
>intended recipient, any dissemination, distribution or copying of this
email
>is not authorized (either explicitly or implicitly) and constitutes an
>irritating social faux pas. Unless the word absquatulation has been used in
>its correct context somewhere other than in this warning, it does not have
>any legal or grammatical use and may be ignored. No animals were harmed in
>the transmission of this email, though the kelpie next door is living on
>borrowed time, let me tell you. Those of you with an overwhelming fear of
>the unknown will be gratified to learn there is no hidden message revealed
>by reading this backwards, so just ignore that Alert Notice from
Macroshaft.
>However, by pouring a complete circle of salt around yourself and your
>computer you can ensure that no harm befalls you and your pets. If you have
>received this eMail in error, please add some nutmeg and egg whites, whisk,
>and place in a warm oven for 40 minutes.
>
>
>
>-----Original Message-----
>From: Paul Collinson [mailto:[log in to unmask]]
>Sent: 06 November 2002 23:59
>To: [log in to unmask]
>Subject: Re: troponin enquiry
>
>
>In message <3DC8FFFD.31796.B68E31@localhost>, Julian Barth <Julianb@PAT
>HOLOGY.LEEDS.AC.UK> writes
>
>
>In view of the key role of cTn in decision making it is unreasonable not
>to provide a service 24/7
>
>The evidence base is compelling so is this another example of the labs
>deciding what should be done (I am being cynical but I wonder how many
>Clinical Biochemists would accept this level of clinical service on the
>receiving end) or financial?
>
>
>
>>Dear Colleagues
>>I am currently being harrassed by our A&E doctors who tell me that
>>many of their colleagues are receiving a 24x7 service for cardiac
>>troponins. I wonder if those of you who do provide this service could
>>let me know and I will collate the answers.
>>
>>Many of you will have taken part in 2 troponin audits performed by
>>Wing Tsang on behalf of the ACB audit group. The findings of these
>>surveys will be published in the Annals soon and will report that the
>>situation is dynamic with many laboratories held back by financial
>>restraints. Interestingly, I have had an email from a colleague in
>>Canada expressing the same problem.
>>
>>I am particularly interested in UK responses who would value replies
>>from anyone.
>>
>>Thanks in advance
>>Julian
>>___________________________________________________
>>
>>Julian H Barth
>>Department of Clinical Biochemistry & Immunology
>>Leeds Teaching Hospitals NHS Trust
>>Leeds General Infirmary
>>Great George Street
>>Leeds LS1 3EX
>>tel 0113-392-3416
>>fax 0113-392-5174
>>___________________________________________________
>>
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>>community working in clinical biochemistry.
>>Please note, archived messages are public and can be viewed
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>>
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>
>--
>Paul Collinson
>
>------ACB discussion List Information--------
>This is an open discussion list for the academic and clinical
>community working in clinical biochemistry.
>Please note, archived messages are public and can be viewed
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>they are responsible for all message content.
>
>ACB Web Site
>http://www.acb.org.uk
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--
Paul Collinson

------ACB discussion List Information--------
This is an open discussion list for the academic and clinical
community working in clinical biochemistry.
Please note, archived messages are public and can be viewed
via the internet. Views expressed are those of the individual and
they are responsible for all message content.

ACB Web Site
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ACB Web Site http://www.acb.org.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/