Point-of-Care Diagnosis of Acute Myocardial Infarction in Central Vietnam

Figures

• 

  FIGURE 1. International symposium speakers and research team in Hue. This figure can be viewed online in color at www.poctjournal.com.

• 

  FIGURE 2. Status of POC and clinical laboratory cardiac biomarker testing in Vietnam. The left frame shows the status in 2016, whereas the right frame, 2017. This geographic information systems analysis of trends over the 2-year period of POCT national development shows that Central Vietnam remains deficient in both POC and clinical laboratory cTnT diagnostic resources. During the survey in TTHP, we found no POC cTnI testing, which generally was deficient in central and far north-south regions. This figure can be viewed online in color at www.poctjournal.com.

• 

  FIGURE 3. Pareto plot showing survey respondent priorities for diagnostic test clusters. The Pareto plot presents perceived priorities for diagnostic test clusters based on survey needs assessment. P values approximate levels of significant differences for the labeled test clusters versus hematology, the one ranked highest. Note that this graphic reflects what respondents stated is needed, not necessarily what is in place already. See Table 4 for additional details.

• 

  FIGURE 4. Risk reduction value proposition for rapid response and improved outcomes. This figure can be viewed online in color at www.poctjournal.com.

• 

  FIGURE 5. Spatial Care Path design for mountainous regions in TTHP. This figure can be viewed online in color at www.poctjournal.com.

• 

  FIGURE 6. Sequence of AMI patient progress in the coastal region. A, Conventional multistep patient evaluation and serial referrals triage involves serial patient steps in the coastal region near Hue in Central Vietnam. First, the patient travels by motorcycle or taxi from home to the level 4 hospital, then subsequently via boat and taxi to the level 3 hospital. Next, if warranted following evaluation, the patient transfers from the level 3 hospital to level 1 or level 2 hospital via ambulance. The sequential referral process is time consuming. B, Accelerated SCP with prehospital POC cTn diagnosis to reduce the number of steps taken, we recommend an efficient SCP for the coastal region near Hue. Diagnosis by means of POC cTn testing near the home or POCT available on an ambulance, along with telehealth ECG and bidirectional radio communication by a cardiologist, would permit the confirmed patient to skip the sequential steps and be transported directly from home to interventional care in the level 1 or level 2 hospital. Therapeutic turnaround time could be optimized. This figure can be viewed online in color at www.poctjournal.com.

• 

  FIGURE 7. Future logic synthesis for rapid intervention for acute chest pain. This figure can be viewed online in color at www.poctjournal.com.

• 

  FIGURE 8. National POCT policy and guidelines documents. A, Malaysia, 2012. B, Thailand, 2015. This figure can be viewed online in color at www.poctjournal.com.