Advertisement
Review Article| Volume 34, ISSUE 1, P75-85, March 2014

The Benefits of a Rapid, Point-of-Care “TnI-Only” Zero and 2-Hour Protocol for the Evaluation of Chest Pain Patients in the Emergency Department

Published:January 16, 2014DOI:https://doi.org/10.1016/j.cll.2013.11.002

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribers receive full online access to your subscription and archive of back issues up to and including 2002.

      Content published before 2002 is available via pay-per-view purchase only.

      Subscribe:

      Subscribe to Clinics in Laboratory Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Wright R.S.
        • Anderson J.L.
        • Adams C.D.
        • et al.
        2011 ACCF/AHA focused update of the guidelines for the management of patients with unstable angina/non–ST-elevation myocardial infarction (updating the 2007 guideline): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines developed in collaboration with the American College of Emergency Physicians, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons.
        J Am Coll Cardiol. 2011; 57: 1920-1959
        • Wu A.H.
        • Apple F.S.
        • Gibler W.B.
        • et al.
        The National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines recommendations for the use of cardiac markers in coronary artery diseases.
        Clin Chem. 1999; 45: 1104-1121
        • Thygesen K.
        • Alpert J.S.
        • Jaffe A.S.
        • et al.
        Third universal definition of myocardial infarction.
        Eur Heart J. 2012; 33: 2551-2567
        • Hart K.W.
        • Lindsell C.J.
        • Ryan R.J.
        A time-and-motion study of the processes required to obtain cardiac biomarker assays using central laboratory, near-patient testing, and bedside point-of-care testing.
        Point Care. 2012; 11: 61-68
        • Storrow A.B.
        • Zhou C.
        • Gaddis G.
        • et al.
        Decreasing lab turnaround time improves emergency department throughput and decreases emergency medical services diversion: a simulation model.
        Acad Emerg Med. 2008; 15: 1130-1135
        • Apple F.S.
        • Chung A.Y.
        • Kogut M.E.
        • et al.
        Decreased patient charges following implementation of point-of-care cardiac troponin monitoring in acute coronary syndrome patients in a community hospital cardiology unit.
        Clin Chim Acta. 2006; 370: 191-195
        • Singer A.J.
        • Ardise J.
        • Gulla J.
        • et al.
        Point-of-care testing reduces length of stay in emergency department chest pain patients.
        Ann Emerg Med. 2005; 45: 587-591
        • Lee-Lewandrowski E.
        • Corboy D.
        • Lewandrowski K.
        • et al.
        Implementation of a point-of-care satellite laboratory in the emergency department of an academic medical center. Impact on test turnaround time and patient ED length of stay.
        Arch Pathol Lab Med. 2003; 127: 456-460
        • Saenger A.K.
        • Jaffe A.S.
        Requiem for a heavyweight: the demise of creatine kinase-MB.
        Circulation. 2008; 118: 2200-2206
        • Lee-Lewandrowski E.
        • Januzzi Jr., J.L.
        • Grisson R.
        • et al.
        Evaluation of first-draw whole blood, point-of-care cardiac markers in the context of the universal definition of myocardial infarction: a comparison of a multimarker panel to troponin alone and to testing in the central laboratory.
        Arch Pathol Lab Med. 2011; 135: 459-463
      1. Abbott Point of Care i-STAT System Cartridge and Test Information sheet. 714258–00N. Rev. 22May12.

        • Apple F.S.
        • Ler R.
        • Murakami M.M.
        Determination of 19 cardiac troponin I and T assay 99th percentile values from a common presumably healthy population.
        Clin Chem. 2012; 58: 1574-1581
        • Bailey T.M.
        • Topham T.M.
        • Wantz S.
        • et al.
        Laboratory process improvement through point-of-care testing.
        Jt Comm J Qual Improv. 1997; 23: 362-380
        • Ryan R.
        • Lindsell C.J.
        • Hollander J.E.
        • et al.
        A multicenter randomized controlled trial comparing central laboratory and point-of-care cardiac marker testing strategies: the Disposition Impacted by Serial Point of Care Markers in Acute Coronary Syndromes (DISPO-ACS) Trial.
        Ann Emerg Med. 2009; 53: 321-328
        • Holland L.L.
        • Smith L.L.
        • Blick K.E.
        Reducing laboratory turnaround time outliers can reduce emergency department patient length of stay: an 11-hospital study.
        Am J Clin Pathol. 2005; 124: 672-674