title: Just point and click. Is your system ready for point-of-care testing?
abstract: Your ALS service is called to evaluate a 47-year-old female with epigastric pain that came on suddenly about six hours ago; she has vomited once. She thought it was the flu and that it would subside, but it has not. She smokes, is overweight and has a family history of early cardiac disease. Her vital signs are unremarkable and her belly is nontender. You perform a 12-lead ECG that shows nonspecific ST-T wave changes inferiorly. You place a few drops of blood obtained as part of your field-drawn bloods into an i-STAT cartridge. The result surprises you: Her cardiac enzyme (troponin I) is markedly elevated. Should she be transported to the closer facility without primary coronary intervention (PCI) capability or further down the road to a facility that has it?
authors.affiliation: Department of Emergency Medicine, Penn State University Hershey Medical Center, USA. mtwiens@yahoo.com
authors.forename: Fritz
authors.initials: F
authors.lastname: Fuller
mesh_terms: D000136:Acid-Base Equilibrium / Q000502:physiology; D054058:Acute Coronary Syndrome / Q000175:diagnosis; D015415:Biomarkers / Q000032:analysis; D004562:Electrocardiography; D004632:Emergency Medical Services / Q000379:methods* / Q000639:trends; D004634:Emergency Medical Technicians / Q000193:education; D006801:Humans; D008991:Monitoring, Physiologic / Q000295:instrumentation* / Q000379:methods; D019095:Point-of-Care Systems / Q000639:trends; D014481:United States; D014882:Water-Electrolyte Balance / Q000502:physiology; D014883:Water-Electrolyte Imbalance / Q000175:diagnosis
chemical_list: D015415:Biomarkers