I have had a query from our A/E Consultant regarding early assessment and
potential discharge of patients with chest pain. We use a single sample
taken at > 12 hours for troponin T as our sole cardiac marker strategy (we
can't afford to do one on admission as well...yet) and his contention is
that he cannot afford to wait for > 12 hrs to elapse as he has no beds. He
wants strategy for all his A/E staff to follow to avoid admitting all such
patients and clogging the system up. Notwithstanding members feelings about
impatience, medicolegal issues, I wondered what, if anything, other
laboratories may have agreed with their A/E Depts (as opposed to MAU's -
ours are ecstatic with trop T).
Philip Hyde,
Consultant Clinical Biochemist,
Pilgrim Hospital,
Boston (UK).
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