Like many other hospitals, we have a problem with triage of patients in
A&E with acute chest pain and non-diagnostic ECG and I have been asked
to look at the use of newer cardiac specific markers in exclusion of AMI
and identification of patients with high risk unstable angina. Having
pointed out that introduction of a 'simple' blood test (how come all
blood tests are 'simple'?) is not going to solve all of the problems and
that testing should be part of protocol-driven procedure, we have
convened a working party to explore options, including establishing a
chest pain evaluation centre.
There is an immense amount of data that has been published and I know
that a meta-analysis is being undertaken, but I would be particularly
interested in local experience such as, how well do Junior Doctors stick
to protocols (especially with regard to timing of samples), required
turnaround time for results, use of POCT and any pitfalls to watch out
for. Examples of local protocols would be much appreciated.
Tony Everitt
Basildon Hospital
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Tony Everitt
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