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Have you ever wondered how it is that your hospital gets paid for the work you do? Perhaps you think that this isn’t relevant to you?

The National Institute for Health and Care Excellence (NICE) from the UK has just published new recommendations for the use of high sensitivity troponin to rule out NSTEMI in the Emergency Department. You can find it at this link.

We see lots of kids presenting to the ED with "things" where they shouldn't be (we see adults too, sometimes - but that's a whole set of different stories). Foreign bodies show up in all sorts of forms in all sorts of places, typically in the preschool and early school age kids who display a potentially deadly combination of curiosity and dexterity with a magpie-like obsession; they just can't keep away from shiny things.

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It's fair to say we quite like a guideline here at St Emlyn's. We have, probably like your ED, evidence-based clinical decision support guidelines for common (think cardiac chest pain and ?PE) and not so common (think porphyria) conditions with the intention of speeding decision-making, delivering safer care and reducing waste on unnecessary admissions and tests.

I was a little miffed about this and learned several lessons that day (notably - always record your images!).