dr-exmedic.com

(Sorry.  It’s a terrible title, but I just had to make fun of a poster I once saw in an ED.)

One of the latest improvements to hit the ED (and primary care offices) to improve efficiency is a broader variety of point-of-care tests.  The prototypical POC test is the urine pregnancy test; a little more advancement led to glucometers, but many other options are now available–including, importantly, tests for cardiac enzymes. 

How effective are these tests?  A recent study of decent size (860 patients) didn’t show any difference in length of ED stay overall, but patients who had their enzymes tested at bedside and needed treatment for heart problems got their treatments 47 minutes earlier, on average.

The way I look at it, these tests are probably the next step in decreasing symptom-to-treatment time prehospitally, particularly in areas with lengthy transport times.  EMS in most places is already calling in the obvious MIs with ECG changes; imagine rolling up to the ED with the patient’s first set of cardiac enzyme results in your hand, or at least running.  It would be even easier to do if the tests were literally as simple as a pregnancy test:  add blood, wait for lines to appear–as this product appears to be.

Of course, there are still regions of the country where the ambulance showing up at your house isn’t equipped with a 12-lead ECG machine (if it’s even an ALS unit at all).  This sort of advancement will continue to pass them by, sadly.

Filed under: EMS Research