Acute Myocardial Infarction

Please note that the Trust uses Surrey Pathology Services which is based at three Surrey hospital sites: Royal Surrey County Hospital; Ashford & St Peter’s Hospitals; Frimley Hospital.

The following responses relate to Royal Surrey County Hospital NHS Foundation Trust only.

• Which test(s) does the Trust use to diagnose patients who present with suspected acute myocardial infarction (AMI)? Please give details of tests used – including the brand and name of the test(s). Clinical assessment, patient history, clinical scores, ECG and Troponin. RSCH uses Troponin I contemporary assay on the Siemens Stratus CS situated in the central laboratory and at the Point of Care. About to change to the Radiometer AQT90 Troponin I assay.

• What, if any, guidelines or protocols does the Trust follow to support the diagnosis of suspected AMI? Please give details. NICE guidelines. See protocol attached below.

Chest Pain Low Risk Protocol June 2015

• Does your Trust use early rule-out protocols to diagnose AMI? If so, please give details. ‘12 hour rule out’ used unless ‘low risk’ patient – ‘low risk chest pain pathway’ used for suitable patients who have Troponin testing at 0, 3 and 6 hours from arrival, and remain under the care of the Emergency Department.

• What is the average waiting time for a diagnosis following a suspected AMI at the Trust? This data is not collated electronically on a central basis.

• What is the target turn-around-time for tests used in the diagnosis of AMI in the Trust? What percentage of tests are performed within this target turn-around-time?

For Troponin:
Central Lab: TAT target for urgent tests is ≥95% within 1 hour from receipt.
For month 6 (Sept 2015) this was met 89% of the time.

POCT: TAT target 99% within 20 minutes at the POC: ≥ 99% achieved unless complete analyser failure.

• How long has the Trust and/or hospitals within the Trust been using their current troponin test(s)? Approximately 15 years.

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