Implementing Point-of-Care Troponin Testing in the Emergency Department: Impact on Time to Result
| Autor: | Jared Sutherland, Benjamin Archer, Kasey Conklin, Dylan Arnold, Michael Hight, Brandi Sakai |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Chest Pain medicine.medical_specialty Acute coronary syndrome Time Factors Point-of-care testing Emergency Nursing Chest pain California Electrocardiography 03 medical and health sciences 0302 clinical medicine Interquartile range medicine Humans 030212 general & internal medicine Acute Coronary Syndrome Point of care biology business.industry Time to result 030208 emergency & critical care medicine Emergency department Middle Aged medicine.disease Troponin Point-of-Care Testing Emergency medicine biology.protein Female medicine.symptom Emergency Service Hospital business |
| Zdroj: | Journal of Emergency Nursing. 47:299-304 |
| ISSN: | 0099-1767 |
| Popis: | In the emergency department, troponin assays are commonly used and essential in the evaluation of chest pain and diagnosis of acute coronary syndrome. This study was designed to assess the potential impact of implementing point-of-care troponin testing by comparing the time to point-of-care laboratory result and time to conventional laboratory result.The study enrolled 60 ED patients deemed to need a troponin test in the evaluation of low-risk chest pain (HEART score4 based on history, electrocardiogram, age, risk factors). Point-of-care troponin testing was performed with the same blood sample obtained for a conventional troponin assay. If the provider determined that the patient required 2 troponin tests, the second laboratory draw was used in the data collection. This was to correlate the time of laboratory result to time of disposition.Of the 60 subjects enrolled, 2 subjects were excluded because of user errors with the point-of-care testing equipment and 2 others for not meeting inclusion criteria on later review. The median times for the point-of-care troponin and conventional troponin assays were 11:00 minutes (interquartile range 10:00-15:30) and 40:00 minutes (interquartile range 31:30-52:30), respectively; P0.001. There were 3 extreme outliers from the conventional troponin assay that significantly skewed the distribution of the mean, making the median the more accurate assessment of the central tendency.Point-of-care troponin testing provided results in a median time 29 minutes quicker than the conventional troponin assay. This result is statistically significant and has the potential to greatly improve time to disposition in all patients with chest pain requiring a troponin assay. |
| Databáze: | OpenAIRE |
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