NSTEACS pathway | Intermediate Care

Intermediate care NSTEMI rule-out

There are 2 ways to navigate this section, by the static flow-chart below or by the buttons

Given NICE CG95's recommendation for an arrival Troponin, patients entering this stream should have been sufficiently clinically assessed during referral to establish a rough pre-test probability of coronary artery disease (via demographics, HPC, PMHx, previous investigations, exam) and differential diagnoses. Failure to do so diminishes the ability to interpret the result.

STEP1: Take bloods including a Troponin on arrival

STEP2: Interpret based on time since chest pain (either clicking the appropriate button below or following the appropriate pathway)

Troponin <5 (either gender)

Troponin <18 (female) or <27 (male)

Troponin >18 (female) or >27 (male)

Combined rule-out pathway

HEART score calculator

RACPC outpatient form (can use MAXIMS)