Is anyone coming under pressure to support POCT Trop testing in ambulances?.
Would they like to share their views / experiences.
I have been summoned to a meeting with South West ambulance services to hear some proposals this week.
I think the measurements are predicated on the ambulances changing route on the basis of a positive "rule in" to centres that offer PCI as opposed to smaller DGH's that do not.
BW John
-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of COLLINS MICHAEL (RM1) Norfolk and Norwich University Hospital
Sent: 06 September 2013 14:37
To: [log in to unmask]
Subject: Re: Troponin for GP patients

We offer troponin to all GPs and telephone all raised results.

Mike Collins
BMS3
Biochemistry Automation
Norfolk & Norwich University Hospital
England
[log in to unmask]
http://www.nnuh.nhs.uk/


On Behalf Of Fiona Davidson
 Sent: 06 September 2013 10:54
 To: [log in to unmask]
 Subject: Troponin for GP patients

 Dear All,

 Are there any labs out there who DON'T offer troponin to  their GPs?

 We are querying whether it is all that helpful - if a  patient appears  clinically to have had an MI then surely they should be  going straight  to A&E?  GPs rarely mark samples as urgent and even  those that do very  often get missed at specimen reception and so get stuck  amongst the  hundreds of other GP samples waiting to be processed.  Once they finally  make it onto the analyser and a result is produced it often  isn't phoned  because the BMS' tend to assume that all raised troponins  are hospital  patients (which don't get phoned out).  All in all the  whole process can  take at least a day and a half or up to 3 days if the sample  came in on  a Friday.

 Add to this the fact that troponin is reportedly only stable  for 24  hours and I'm not sure we are offering a particularly useful  service  here.

 When I have gone back and looked at the patients who had a  GP raised  troponin it didn't look like many of them were followed up  with a second  sample or even a hospital admission.  The majority of  these are only  slightly raised ? due to e.g. CKD.

 So my question is: would these patients be better served if  we didn't  offer GP troponin so that all those with a high probability  of MI come  straight to hospital?  Has anybody done any work on  this?

 Thanks

 Fiona Davidson
 Senior Biochemist
 Kingston Hospital NHS Trust

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