Women aged 55+ are the fastest growing employment demographicĤ. By 2022, 14.5 million more jobs will be created, but only 7 million younger workers will enter the workforce – this represents a 7.5 million gapģ. By 2020 the over 50s will comprise almost one-third of the working age populationĢ. Surveys repeatedly state that Millennials value feedback, communication, flexibility and opportunityġ. Those women who do go to university are more likely to get a 2.1 or above than their male counterpartsĤ. Women are now a third more likely to go to university than menģ. The government has just confirmed that the Menopause will be included in the school curriculumĢ. Paramedics can use the HEAR score to discriminate risk, but even when used in combination with out-of-hospital point-of-care cTnI testing, the HEART score does not safely rule out major adverse cardiac events, and only a small proportion of patients are identified as high risk.Ĭopyright © 2021 American College of Emergency Physicians. A point-of-care HEART score less than or equal to 3 identified a similar proportion as low risk (30%), with a sensitivity of 87.0% (95% CI 80.7% to 93.4%), whereas a score greater than or equal to 7 identified 14% as high risk, with a specificity of 94.8% (95% CI 92.0% to 97.5%). A HEAR score less than or equal to 3 identified 32% of patients (334/1,054) as low risk, with a sensitivity of 84.9% (95% confidence interval 80.7% to 89%), whereas a score greater than or equal to 7 identified just 3% of patients (30/1,054) as high risk, with a specificity of 98.7% (95% CI 97.9% to 99.5%). The HEAR score was calculated in all patients, with point-of-care cTnI testing available in 357 (34%). Of 1,054 patients (64 years 42% women), 284 (27%) experienced a major adverse cardiac event at 30 days. HEAR and HEART scores less than or equal to 3 and greater than or equal to 7 were defined as low and high risk for major adverse cardiac events at 30 days. The History, ECG, Age and Risk Factors (HEAR) score was recorded contemporaneously, and out-of-hospital samples were obtained to measure cardiac Troponin I (cTnI) level on a point-of-care device, to allow calculation of the History, ECG, Age, Risk Factors, and Troponin (HEART) score. Paramedics prospectively enrolled patients with suspected acute coronary syndrome without diagnostic ST-segment elevation on the ECG. To determine whether risk stratification in the out-of-hospital setting could identify patients with chest pain who are at low and high risk to avoid admission or aid direct transfer to cardiac centers.
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