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Crowding of our hospitals and emergency departments (EDs) is not a new issue, but the COVID-19 pandemic has now taken it to another level. The recent pressures highlight the importance of sparing vital inpatient resources for those who really need them. They help us to appreciate the dangers of allowing those resources to be consumed by patients undergoing diagnostic evaluation for a condition that they probably do not have, especially when they would not otherwise require any inpatient care.
Fortunately, we now have numerous evidence-based pathways that can help us. Following a single blood test in the ED, some patients could be immediately discharged, either using low troponin cut-offs1 2 or a decision aid.3 4 For those who have not been discharged after a single blood test, the second blood test can now be drawn much earlier (1 to 3 hours after the first sample) than was previously possible.5 …
Contributors RB is the sole author of this work.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests Research grants to my institution: Abbott Point of Care Advisory boards: Abbott Point of Care; Roche; Siemens Healthineers; LumiraDx; Creavo.
Patient and public involvement Patients and/or the public were not involved in the design, conduct, reporting or dissemination plans of this research.
Patient consent for publication Not required.
Provenance and peer review Commissioned; internally peer reviewed.
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