The efficacy of the HEART score in prehospital settings
Journal of Paramedic Practice · 2022-05-02 · Other / unclear
Abstract
Background: HEART scores are a well-validated tool used to risk stratify patients with chest pain in the emergency department. Currently, no triage or risk stratification tool is available in the UK prehospital arena. Methods: A comprehensive literature search was carried out to determine the effectiveness of HEART score use by paramedics in the prehospital environment. Findings: Prehospital HEART scores completed by paramedics appear to have a high sensitivity and negative predictive value for detecting major adverse cardiac events. The use of high-sensitivity cardiac troponin assays or a prehospital modified HEART Pathway may allow patients to be triaged based on a single point-of-care (POC) cardiac troponin test. As POC devices improve, this is likely to increase the accuracy of paramedic HEART scores. Additionally, there are some differences between HEART scores calculated by doctors and paramedics. Conclusion: The use of HEART scores prehospitally has the potential to improve patient outcomes. However, issues remain over the accuracy of POC devices and with paramedic interpretation of electrocardiograms and cardiac history-taking. Furthermore, the lack of POC testing in current UK paramedic scopes of practice raises questions over the practicality of introducing HEART scores, which would rely on POC testing.
Abstract © the authors or publisher, via OpenAlex. Reuse and removal
Tags
Paramedics & EMTs · Point-of-care tests · Triage instruments
Related articles
- Acute rule-out of non-ST-segment elevation acute coronary syndrome in the (pre)hospital setting by HEART score assessment and a single point-of-care troponin: rationale and design of the ARTICA randomised trial. (BMJ Open, 2020)
- Prehospital risk stratification in suspected non-ST-segment elevation acute coronary syndrome with point-of-care troponin: an individual patient data meta-analysis. (Heart, 2026)
- Prehospital risk assessment in patients suspected of non-ST-segment elevation acute coronary syndrome: a systematic review and meta-analysis. (BMJ Open, 2022)
- Performance of the HEART Score in pre-hospital settings for suspected non-ST-elevation acute coronary syndrome: The POPular HEART Study. (Neth Heart J, 2026)
- Integrating GFAP Testing With Clinical Scores for Prehospital Large Vessel Occlusion Detection in Patients With Acute Stroke (DETECT LVO). (Stroke, 2026)
- Diagnostic Accuracy of a Novel Point of Care High-Sensitivity Troponin Assay in the Prehospital Environment. (Acad Emerg Med, 2026)