PMID- 30973857
OWN - NLM
STAT- MEDLINE
DCOM- 20191023
LR  - 20191023
IS  - 1175-8716 (Electronic)
IS  - 0028-8446 (Linking)
VI  - 132
IP  - 1493
DP  - 2019 Apr 12
TI  - Point-of-care troponin use in New Zealand rural hospitals: a national survey.
PG  - 25-37
AB  - AIMS: Accelerated diagnostic chest pain pathways (ADP) have become standard of 
      care in urban emergency departments. It is, however, unknown how widely they are 
      used in New Zealand's rural hospitals because ADP require immediate access to 
      contemporary or high-sensitivity troponin (hs-Tn). We aimed to determine for 
      rural hospitals the troponin assay being used, if they were using an ADP and if 
      they had access to on-site exercise tolerance testing (ETT). METHODS: An online 
      survey was sent to 27 rural hospitals providing acute care in New Zealand. 
      RESULTS: Most rural hospitals (23/27, 85%) responded to the survey. Most (17/23, 
      74%) used point-of-care cardiac troponin (POC-cTn) and the majority of these 
      hospitals (15/17, 88%) were reliant on this assay 24-hours per day. All hospitals 
      that had timely access to hs-Tn (8/23, 35%) used an ADP but only a minority 
      (4/17, 24%) of hospitals using POC-cTn used an ADP. Only a minority of the larger 
      rural hospitals (7/23, 30%) had access to on-site ETT. CONCLUSIONS: Most New 
      Zealand rural hospitals rely on POC-cTn to assess chest pain and are not using an 
      ADP. There are limited data available to support this approach in rural settings 
      especially with patients who are not low-risk.
FAU - Miller, Rory
AU  - Miller R
AD  - Senior Lecturer: Rural Post-Graduate Programme, Dean's Department, Dunedin School 
      of Medicine, University of Otago, Dunedin; Rural Doctor, Thames Hospital, Waikato 
      District Health Board, Waikato.
FAU - Stokes, Tim
AU  - Stokes T
AD  - Elaine Gurr Professor of General Practice and Head of Department, Department of 
      General Practice and Rural Health, Dunedin School of Medicine, University of 
      Otago, Dunedin.
FAU - Nixon, Garry
AU  - Nixon G
AD  - Head of Rural Section and Associate Dean Rural: Department of General Practice 
      and Rural Health, Dunedin School of Medicine, University of Otago, Dunedin; Rural 
      Doctor, Dunstan, Central Otago Health Services.
LA  - eng
PT  - Journal Article
DEP - 20190412
PL  - New Zealand
TA  - N Z Med J
JT  - The New Zealand medical journal
JID - 0401067
RN  - 0 (Troponin)
SB  - IM
MH  - Acute Coronary Syndrome/*blood/diagnosis
MH  - Chest Pain/etiology
MH  - Female
MH  - Hospitals, Rural/organization & administration
MH  - Humans
MH  - Male
MH  - Myocardial Infarction/*blood/diagnosis
MH  - New Zealand
MH  - Point-of-Care Systems/*organization & administration
MH  - Rural Health/standards
MH  - Troponin/*blood
COIS- Nil.
EDAT- 2019/04/12 06:00
MHDA- 2019/10/24 06:00
CRDT- 2019/04/12 06:00
PHST- 2019/04/12 06:00 [entrez]
PHST- 2019/04/12 06:00 [pubmed]
PHST- 2019/10/24 06:00 [medline]
PST - epublish
SO  - N Z Med J. 2019 Apr 12;132(1493):25-37.