Prehospital Point-of-Care Testing for Troponin: Are the Results Reliable?

Venturini, Joseph; Stake, Christine E.; Cichon, Mark

doi:10.3109/10903127.2012.717166

Cited by 15 publications

(6 citation statements)

References 7 publications

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“…Sex disparities in favour of male patients have also been reported in a study of EMS stroke recognition [21]. The introduction of point-of-care testing has been shown to be feasible in the EMS [22] and may aid further in complex assessments.…”

Section: Transported and Non-transported Patientsmentioning

confidence: 93%

Patient characteristics, triage utilisation, level of care, and outcomes in an unselected adult patient population seen by the emergency medical services: a prospective observational study

2020

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Background: Crowding in the emergency department (ED) is a safety concern, and pathways to bypass the ED have been introduced to reduce the time to definitive care. Conversely, a number of low-acuity patients in the ED could be assessed by the emergency medical services (EMS) as requiring a lower level of care. The limited access to primary care in Sweden leaves the EMS nurse to either assess the patient as requiring the ED or to stay at the scene. This study aimed to assess patient characteristics and evaluate the initial assessment by and utilisation of the ambulance triage system and the appropriateness of non-transport decisions. Methods: A prospective observational study including 6712 patients aged ≥16 years was conducted. The patient records with 72 h of follow-up for non-transported patients were reviewed. Outcomes of death, time-critical conditions, complications within 48 h and final hospital assessment were evaluated. The Mann-Whitney U test, Fisher's exact test, and Spearman's rank correlation were used for statistical analysis. Results: The median patient age was 66 years, and the most common medical history was a circulatory diagnosis. Males received a higher priority from dispatchers and were more frequently assessed at the scene as requiring hospital care. A total of 1312 patients (19.7%) were non-transported; a history of psychiatric disorders or no medical history was more commonly noted among these patients. Twelve (0.9%) of the 1312 patients not transported were later admitted with time-critical conditions. Full triage was applied in 77.4% of the cases, and older patients were triaged at the scene as an 'unspecific condition' more frequently than younger patients. Overall, the 30-day mortality was 4.1% (n = 274). Conclusions: Age, sex, medical history, and presentation all appear to influence the initial assessment. A number of patients transported to ED could be managed at a lower level of care. A small proportion of the non-transported patients were later diagnosed with a time-critical condition, warranting improved assessment tools at the scene and education of the personnel focusing on the elderly population. These results may be useful in addressing resource allocation issues aiming at increasing patient safety.

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Section: Transported and Non-transported Patientsmentioning

confidence: 93%

Patient characteristics, triage utilisation, level of care, and outcomes in an unselected adult patient population seen by the emergency medical services: a prospective observational study

2020

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“…Many studies have been performed that show the time to diagnosis is faster when POC testing is used (Goodacre et al, 2011). Electrocardiogram testing and POC devices measuring cardiac troponin I levels have been used in a moving ambulance and showed good correlation to tests that were performed in the ED (Venturini et al, 2013). …”

Section: Emergency Departmentmentioning

confidence: 99%

Point-of-care diagnostics for niche applications

Cummins

Ligler

Walker

2016

Biotechnology Advances

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Point-of-care or point-of-use diagnostics are analytical devices that provide clinically relevant information without the need for a core clinical laboratory. In this review we define point-of-care diagnostics as portable versions of assays performed in a traditional clinical chemistry laboratory. This review discusses five areas relevant to human and animal health where increased attention could produce significant impact: veterinary medicine, space travel, sports medicine, emergency medicine, and operating room efficiency. For each of these areas, clinical need, available commercial products, and ongoing research into new devices are highlighted.

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“…In the study conducted by Venturini and colleagues, it was found that there was no significant difference between POCT devices operated in a moving ambulance and the measurement of cardiac troponin I levels obtained by POCT devices in the emergency department [22]. This confirms the practicality and utility of POCT in prehospital emergency contexts especially in future events of pre-hospital myocardial infarction.…”

Section: Current Practices On Poct In Pre-hospital Emergency Medicinementioning

confidence: 78%

Point-of-care testing as the future of pre-hospital emergency medicine: an overview

2021

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Point-of-care testing (POCT) plays an increasingly important role in pre-emergency medicine by ensuring that patient’s continuum of care is commenced before arrival at health facilities. Given the benefits of POCT during the COVID-19 pandemic, this commentary described the advantages and disadvantages of POCT, and its current practices in pre-hospital emergency medicine. Point-of-care tests are easy to operate, cost-effective, and yield quick and accurate response, but are posed with challenges such as safety errors, poor adherence to quality control standards, and inspection errors. To optimize the benefits of POCT in pre-emergency medicine, it is required that regular trainings are conducted for POCT operators, and total compliance to POCT handling and management guidelines should be considered by each POCT operator.

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Prehospital Point-of-Care Testing for Troponin: Are the Results Reliable?

Cited by 15 publications

References 7 publications

Patient characteristics, triage utilisation, level of care, and outcomes in an unselected adult patient population seen by the emergency medical services: a prospective observational study

Patient characteristics, triage utilisation, level of care, and outcomes in an unselected adult patient population seen by the emergency medical services: a prospective observational study

Point-of-care diagnostics for niche applications

Point-of-care testing as the future of pre-hospital emergency medicine: an overview

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