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viernes, 21 de septiembre de 2018

High Sensitivity Troponin Protocols in the ED

Dr. Smith's ECG Blog

Dr. Smith´s ECG Blog - September 21, 2018 - By Steve Smith
High Sensitivity Troponin; Considerations for Implementing ED protocols.
"There is a huge amount of new data since 2015, and it will keep accumulating.
I have tried to distill a huge literature down to fewer important studies, and I give my bottom line summary, but there is still a huge amount of data. This is my reading of the literature. It is not peer-reviewed. I'm sure there are many who would disagree with my summary slides. But I present a lot of data so that you can make your own decision. A file of the outline of the slides can be accessed on my Google Drive via the link.
The purpose of this lecture is to expose you to the broad spectrum of high sensitivity based protocols that your ED might choose from. You will not be able to use it on your next patient, but use it to institute a protocol that works for your institution. So just sit back and listen.
One thing I forgot to address in the lecture: Acute Occlusion Myocardial infarction (OMI). There is no evidence that hs troponin will help in the early diagnosis of acute coronary occlusion vs. non-occlusive MI. It does help in early diagnosis of MI (of OMI/NOMI), but does not differentiate.
Thanks to Scott Joing for recording this. Scott is our tech wizard and fine emergency physician, and co-editor of Ma and Mateer's standard EM ultrasound textbook. He is the creator of www.hqmeded.com.
Also thanks to my incredibly bright and knowledgeable troponin research partners, both of whom know much more about troponin than I do. They are Fred Apple and Yader Sandoval (https://twitter.com/yadersandoval), and also to the Cardiac Biomarkers Research Lab, especially Karen Schulz, at Hennepin and Minneapolis Medical Research Foundation.
High Sensitivity Troponin; Considerations for Implementing ED protocols."
The text of the slides can be seen here in .rtf format:
High Sensitivity Troponins from HQMedEd on Vimeo.