The New Zealand medical journal
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General practitioners are able to measure cardiac troponin in order to help triage patients with symptoms suspicious of acute coronary syndrome. The aim of this study was to assess the utilisation of cardiac troponin testing in the community. ⋯ The use of troponin in the community appropriately triages patients regarding the need for admission. However, many patients had elevated troponin due to non-coronary causes. The indication for testing only in cases of suspected ACS and the use of serial cTn measurement in early presenters should be emphasised.
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The aims of the study were to review small-bore chest tube insertion practices for drainage of pleural fluid at Hutt Valley District Health Board (HVDHB), to assess complications, and compare the findings with international data. ⋯ Chest drain complication rates at HVDHB were comparable to those seen internationally. Referral rates to cardiothoracic surgery for empyema were within described ranges. The importance of procedural training for junior medical staff, optimising safety of drain insertions with ultrasound guidance, and clear clinical governance for chest tube insertions are important in minimising harm from this procedure. Specialist societies need to take a leadership in providing guidance on chest drain insertions to secondary and tertiary hospitals in Australia and New Zealand.