Point-of-care testing
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Point-of-care testing (POCT) is defined as diagnostic testing at or near the site of patient care.[1] The driving notion behind POCT is to bring the test conveniently and immediately to the patient. This increases the likelihood that the patient will receive the results in a timely manner.
POCT is accomplished through the use of transportable, portable, and handheld instruments (e.g., blood glucose meter, nerve conduction study device) and test kits (e.g., CRP, HBA1C, Homocystein, HIV salivary assay, etc.). Cheaper, smaller, faster, and smarter POCT devices have increased the use of POCT approaches by making it cost-effective for many diseases, such as diabetes, carpal tunnel syndrome(CTS)[2] and acute coronary syndrome.
Contents
Technology
Many point-of-care test systems are realized as easy-to-use membrane-based test strips, often enclosed by a plastic test cassette. This concept often is realized in test systems for detecting pathogens. Very recently such test systems for rheumatology diagnostics have been developed, too.[3] These tests require only a single drop of whole blood, urine or saliva, and they can be performed and interpreted by any general physician within minutes.
A list of tests most appropriate to particular scenarios
Primary care
Glucose, HbA1C, microalbumin, electrolytes, cholesterol, C-reactive protein, urinalysis, chlamydia, HIV, coagulation markers, streptococcal infection
Emergency room
electrolytes, blood gases and H+, glucose, creatinine, amylase, drugs (overdose and abuse), cardiac markers, brain-specific proteins, coagulation markers
Intensive care
electrolytes, ionised calcium and magnesium, blood gases and H+, glucose, lactate, osmolality creatinine, hemoglobin, prothrombin time
Benefits
Major benefits are obtained when the output of a POCT device is made available immediately within an electronic medical record. Results can be shared instantaneously with all members of the medical team through the software interface enhancing communication by decreasing turn around time (TAT). A reduction in morbidity and mortality has been associated with goal-directed therapy (GDT) techniques when used in conjunction with POCT and the electronic medical record.[4]
POCT has become established worldwide[5] and finds vital roles in public health[6]. Many monographs in the Thai[7][8] and Indonesian [9] languages emphasize POCT as the normal standard of care.
Potential operational benefits of POCT:More rapid decision making and triage, reduce operating times, reduce high-dependency, postoperative care time, reduce emergency room time, reduce number of outpatient clinic visits, reduce number of hospital beds required, ensure optimal use of professional time.
References
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<references />, or <references group="..." />- ↑ Kost, Gerald J. (2002). "1. Goals, guidelines and principles for point-of-care testing". Principles & practice of point-of-care testing. Hagerstwon, MD: Lippincott Williams & Wilkins. pp. 3–12. ISBN 0-7817-3156-9.
- ↑ Tolonen U; et al. (2007). "A handheld nerve conduction measuring device in carpal tunnel syndrome". Acta Neurol Scand. 115 (6): 390–7. doi:10.1111/j.1600-0404.2007.00799.x. PMID 17511847.
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- ↑ Tran NK, Kost GJ (2006). "Worldwide point-of-care testing: compendiums of POCT for mobile, emergency, critical, and primary care and of infectious diseases tests". Point of Care: the Journal of Near-Patient Testing & Technology. 5: 84–92.
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- ↑ Kost, G.J. (2006). "1. Overview of point-of-care testing: Goals, guidelines, and principles". In Charuruks N. Point of Care Testing for Thailand (in Thai). Bangkok. pp. 1–28.
- ↑ Kost, G.J. (2006). "10. Point-of-care testing in province hospitals and primary care units (PCUs): Optimizing critical care and disaster response". In Charuruks N. Point of Care Testing for Thailand (in Thai). Bangkok. pp. 159–77.
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