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Wouldn't matter if you could...Nor do we have the ability to check it in the field (usually).
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Wouldn't matter if you could...Nor do we have the ability to check it in the field (usually).
I disagree. If I could check troponin levels, I could use that to help paint a clinical image in combination with patient presentation and the ECG. Also, it could be used as an intial measurement in delta trops, which doesn't help me, but does help the patient.Wouldn't matter if you could...
would you base where you brought the patient if you could measure troponin?I disagree. If I could check troponin levels, I could use that to help paint a clinical image in combination with patient presentation and the ECG. Also, it could be used as an intial measurement in delta trops, which doesn't help me, but does help the patient.
Probably not. That's not the question I was answering. I was answering your point that it doesn't matter if we check trops.would you base where you brought the patient if you could measure troponin?
Probably not. That's not the question I was answering. I was answering your point that it doesn't matter if we check trops.
I think so too, which makes sense since that's where the line of conversation was going. I was just commenting that there isn't no point at all.I think he was referring to destination and treatment plans.
No point? In our current County, we have seen an influx in patients being transported to non Cardiac facilities. Transports where paramedics have trop. Results from clinics. For example Kaiser.I think so too, which makes sense since that's where the line of conversation was going. I was just commenting that there isn't no point at all.
The best determination of what treatment the patient needs (and by extension, where) is the whole purpose of EMS. Nothing else does matter. What do you mean by "helps the patient"? Benefit is a very broad category that requires randomized control trials to determine.Probably not. That's not the question I was answering. I was answering your point that it doesn't matter if we check trops.
Ok, fine. You run a POC troponin and it comes back normal. Now what?No point? In our current County, we have seen an influx in patients being transported to non Cardiac facilities. Transports where paramedics have trop. Results from clinics. For example Kaiser.
Then they have to get transferred out once again to a hospital that has Cath Lab capabilities. Which could have been avoided if Paramedics had basic training on basic labs.
I don’t see how Trop. Levels would be useless.
Then you run your show as you please.Ok, fine. You run a POC troponin and it comes back normal. Now what?
What do you mean by "helps the patient"? Benefit is a very broad category that requires randomized control trials to determine.
You'll have to tell me....can NSTEMI's go to any hospital where you are? Because you could be home from your shift before your patient's troponin bumped. There is a long list of non-cardiac causes of troponin elevation too. As far as hospital staff getting ticked off...at the ambulance crews? For misinterpreting a hospital based biomarker test? I'm definitely missing something there.Then you run your show as you please.
What if it comes back high/abnormal? Seems to me that many disregard the result, and get hospital staff annoyed/ticked.
So how do you determine a "useable" clinical result (as opposed to an un-useable?) Are they going to use your POC instrument? Is it a high sensitivity test? Does the hospital use a different assay? Way more to the issue than good intentions and what may seem like common sense. You get normal levels and transport accordingly. The non-PCI capable hospital you bring them to follows the cTn for the next 8-16 hours then transfers for NSTEMI. What have you accomplished?They're going to run delta trops in the ER. The sooner that is complete, the sooner they can get a useable clinical result, reduce LOS, and speed up the process. No randomized controlled trials needed to know that the less time a patient has to spend waiting in the ER, the better.
I think you missed the point at the first post.You'll have to tell me....can NSTEMI's go to any hospital where you are? Because you could be home from your shift before your patient's troponin bumped. There is a long list of non-cardiac causes of troponin elevation too. As far as hospital staff getting ticked off...at the ambulance crews? For misinterpreting a hospital based biomarker test? I'm definitely missing something there.
Troponin leak from kidney issues, fluid overload or missed dialysis. Yeah bud, never required a stemi/heart center/cath lab to fix those for my dad.My apologies. I should have been more specific. Turns out many Paramedics have no clue what troponin is.
to go back to the OP, monitors have issues: They need people to remind them that the patient isn't isn't dead when it thinks they are.
Whelp, that surprised me. I always thought EPs were good at it.Is that an appropriate I will say, it looks like even EPs don't have great accuracy at reading ECGs, but it seems close to paramedic read quality.