Nursing Management 's article "POC testing of cardiac markers enhances ED care," (September 2002) could mislead nurses into believing that all laboratories have the same normal reference range for every test. The author states that "Troponin levels greater than 0.01 ng/ml for either type as elevated, and values greater than 0.1 ng/ml as markedly elevated, indicate a high risk of death." Our laboratory's methodology has a normal reference range of 0 to 2.0 with a critical value set at 4.0.

Each lab must set its own normal reference range, depending on the methodology it uses. I wouldn't want a nurse to assume from this article that all troponin reference range values are the same for every laboratory.

Janie Word, MT(ASCP), CIC