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Adult nursing
Are we ready for prehospital troponin testing by paramedics?
  1. Christiaan J M Vrints
  1. Cardiology, University Hospital Antwerp, Edegem, Belgium
  1. Correspondence to Dr Christiaan J M Vrints, University Hospital Antwerp, Edegem, 2650, Belgium; christiaan.vrints{at}

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Commentary on: Dawson LP, Nehme E, Nehme Z, Zomer E, Bloom J, Cox S, Anderson D, Stephenson M, Ball J, Zhou J, Lefkovits J, Taylor AJ, Horrigan M, Chew DP, Kaye D, Cullen L, Mihalopoulos C, Smith K, Stub D. Chest Pain Management Using Prehospital Point-of-Care Troponin and Paramedic Risk Assessment. JAMA Intern Med. 2023 Mar 1;183(3):203-211. doi: 10.1001/jamainternmed.2022.6409.

Implications for practice and research

  • In patients calling the emergency medical system for acute chest pain without ST-segment elevation, prehospital risk stratification using validated risk scores and point-of-care (POC) cardiac troponin measurement by emergency nurses or paramedics can result in substantial cost savings.

  • The safety of this strategy needs confirmation by sufficiently powered prospective randomised clinical trials.


Acute chest pain is one of the most common reasons for emergency system activation and transfer to the emergency department (ED).1 Only a minority of …

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.