Pete Best
Journal of Paramedic Practice, Vol. 9, Iss. 4, 07 Apr 2017, pp 165 - 170

The 'Paramedic Pathfinder', a triage tool for paramedics, contains a discriminator
for patients complaining of non-traumatic chest pain. The pathfinder advises
all patients with non-traumatic chest pain to be taken to hospital. Given a
background of large numbers of patients complaining of chest pain and the
policy direction of UK ambulance services to treat patients closer to home, the
inclusion of discriminator in the pathfinder can be challenged.

A greater understanding of ACS, university education for paramedics, bedside
troponin measurement, ACS risk scoring, current NICE guidelines and rapid
access chest pain clinics have been identified as enablers to remove the
discriminator safely and assist paramedics in finding suitable alternatives to
Accident and Emergency for certain patients.

Risk is an important factor in discussing chest pain and establishing the
best pathway for patients. The enablers identified need further testing and
development in the pre-hospital environment before they can be utilised.

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