A quick blood test in the ambulance can ensure more effective treatment of patients with blood clots in the heart, according to a survey carried out by the Department of Clinical Medicine, which undertakes research among patients.

Chest pain and breathing difficulties. Unpleasant symptoms that should make you call emergency services. Immediately. In the ambulance, the medics can take an ECG and send it to the hospital. Here, a doctor will assess whether the patient has a blood clot and whether it requires surgery, typically an emergency balloon dilation procedure.
“The doctor has to determine very quickly whether the ­patient should be transported to a larger hospital where ­
the surgery can be carried out, or whether transport to a smaller, local hospital is sufficient. However, in some cases, ­­a diagnosis cannot be made on the basis of an ECG,” says Dr Jacob Thorsted Sørensen, Department of Clinical ­Medicine at Aarhus University Hospital, Skejby. He therefore came up with an idea for a test that can improve the diagnostic procedure in the ambulances.
“In 2008, we launched a project in which the medics took blood samples – in addition to taking an ECG – from patients with symptoms of blood clots in the heart. The project turned out to be a great success and the procedure has now been implemented as standard practice throughout the region,” ­Dr Sørensen says.

A quick diagnosis can mean the difference between life and death

This is the first time researchers have demonstrated that blood tests can supplement the diagnostic procedure in the ambulances and that the medics can successfully carry out the blood tests. These show whether the blood contains a special protein – troponin – which can be present in heart muscle. If the blood sample contains troponin, it invariably means that there is damage to heart cells. The blood test in the ambulance enables the doctors to make a more ­accurate diagnosis sooner and thereby saves valuable time,” Dr Sørensen explains.
“It’s really about directing the heart patient to the right hospital as soon as possible. If the patient has a blood clot that requires surgery, the ambulance should head straight to one of the five hospitals in Denmark that can carry out the surgery, for example Aarhus University Hospital in Skejby. If the ambulance stops at a smaller hospital, time is lost,” he says.
“Valuable minutes can be lost just carrying a patient in and out of the ambulance, and mortality increases by ten per cent every hour.”

Patient research

Dr Sørensen is in no doubt that it was essential for the survey that it was carried out at precisely the Department of Clinical Medicine, Aarhus University. What is unique about the Aarhus model is, in fact, that the Department of ­Clinical Medicine carries out its research at the hospitals in the ­region.
“We have excellent opportunities for carrying out research among patients here at Aarhus University. As researchers, ­we therefore have a lot of freedom and are able to tackle specific issues at the clinics. The idea of taking blood samples in the ambulances wouldn’t have arisen if we hadn’t been out among the patients and seen that there was something that could be improved,” Dr Sørensen says.
The results of the study have been published in The ­American Journal of Cardiology.