POINT-OF-CARE TESTING
Rethinking emergency cardiac care: challenging the status quo
A novel high-sensitivity troponin point-of-care test has the potential to have a positive impact on accident and emergency departments. Professor Paul Collinson discusses how this new technology could help the NHS, and his involvement in a study evaluating it.
How do you perceive the ongoing challenges regarding A&E overcrowding and ambulance delays? Professor Paul Collinson: We have reached a point where hospitals are now so overcrowded they face the potential to become inefficient and at worst, dangerous. Furthermore, there is an unsustainable demand for the emergency ambulance services which is impaired by lengthy patient hand-over delays. One of the problems is that staff are so overwhelmed just trying to keep the system going that they do not have time to think creatively. This is exacerbated by a management mindset that does not seem able or willing to work collaboratively with clinicians to try and do anything other than respond to the latest diktat from the Department of Health, even if it makes the situation worse rather than better.
Another thing which has also been
forgotten is the experience of the patient. I have had the misfortune of accompanying both of my parents to the emergency department over the past two years and the experience was utterly miserable. Therefore, any strategy which aims to improve patient flow should be fully embraced and funded, once proven to be clinically effective. Although everyone appreciates the pressures on the new government’s budget, nothing is going to be achieved without the funding to look at new technologies and new ways of working. We need greater investment, and we need it now.
The majority of patients who present at A&E with chest pain do not have a final diagnosis of coronary disease. About 50% of patients can be discharged without further hospitalisation.
WWW.PATHOLOGYINPRACTICE.COM OCTOBER 2024
With chest pain constituting about 5-6% of all A&E attendances, what are your thoughts on its implications? PC: A patient presenting with chest pain constitutes a medical emergency, as this is a primary symptom of myocardial
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