During the COVID-19 emergency trusts will continue to care for patients with serious conditions other than coronavirus.
Patients with acute chest pain will present to accident and emergency departments and require treatment from significantly overstretched staff.
High-sensitivity cardiac troponin tests are able to detect very low levels of the cardiac biomarker released after a heart attack. As part of a validated treatment pathway, this can support the rapid rule-out or diagnosis of a cardiac cause of chest pain.
Being able to detect subtle changes in cardiac troponin reduces the time-to-diagnosis from up to 12 hours to less than four hours and significantly reduces unnecessary hospital admissions.
The Innovation Agency is supporting the adoption of high-sensitivity cardiac troponin testing at trusts across the North West Coast. Evidence shows that, using validated assessment pathways, some patients can be safely released from the emergency department after a single troponin test, and many after two tests, three hours apart. The work is being led by Dr Aleem Khand, cardiologist at Liverpool University Hospitals Foundation Trust, where the Liverpool Acute Chest Pain proforma was developed.
Trusts that adopt these pathways, which have been recommended by NICE, will be able to more efficiently allocate their resources because of the reduced time-to-diagnosis. Rapid rule-out of heart attack as the cause of chest pain will allow staff to safely release patients from hospital.
Cases of chest pain account for around five per cent of all emergency admissions, of which only about 20 per cent will be diagnosed as heart attacks. It is therefore important to diagnose true MI cases as soon as possible as well as discharge non-MI cases.
The Innovation Agency is also leading this as a national project in partnership with the NHS Accelerated Access Collaborative, providing support to other AHSNs and trusts who want to adopt this process .The Innovation Agency Coaching Academy is able to provide support to those trusts wanting to adopt high-sensitivity troponin.
A series of webinars and virtual coaching is being delivered.
The first webinar was presented by Professor of Emergency Medicine Rick Body, Consultant Chemical Pathologist Professor Paul Collinson and Interventional Cardiologist Dr Aleem Khand.