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Point-of-Care Testing vs. Laboratory Testing during High Patient Volume Situations

Open Journal of Emergency Medicine 2019年第4期7卷 49-56页

作者： Jonathan McCoy Robert Eisenstein Channing Hui greg corcoran Chris Kilker Pamela Ohman-Strickland Mark Merlin Clifton Lacy Rutgers-Robert Wood Johnson Medical School Department of Emergency Medicine (RWJMS) New Brunswick NJ USA Alpert Medical School of Brown University Department of Medicine Division of Pulmonary Critical Care and Sleep Medicine Providence RI USA Capital Health Emergency Department Trenton NJ USA Rutgers-School of Public Health (SPH) Piscataway NJ USA Newark Beth Israel Medical Center Department of Emergency Medicine Newark NJ USA Rutgers-Robert Wood Johnson Medical School Rutgers School of Communication and Information New Brunswick NJ USA

Introduction: Our aim was to determine what patient volume, if any, in-laboratory testing provides results faster than Point-of-Care-Testing (POCT). Methods: To evaluate POCT effectiveness during high volume situations, POCT was compared to in-laboratory testing during busy periods with large numbers of patients. Our setting was an urban level 1 trauma center with an academic emergency medicine department (ED) and annual patient volume of 70,000. Patients seen requiring laboratory testing during peak volume between 11 a.m. and 7 p.m. were enrolled over a five-week period. One tube of blood was sent to the laboratory and the other tube was run in the ED using POCT. Turnaround time was recorded as time from when the tube was received to when the result was available. We also completed a time-motion study to assess the number of POCT machines that would be needed to process the entire average hourly hospital laboratory volume. Results: We collected 539 hematology and chemistry specimens. The POCT group was significantly faster than in-laboratory testing, with mean POCT [complete blood count (CBC) and chemistry] 3.5 minutes compared to in-laboratory CBC test time of 30.9 minutes and chemistry test time of 55 minutes. As the volume of samples peaked, there was a slight but insignificant decrease in POCT turnaround time. If POCT was used to process the entire average hospital laboratory volume which approached 54 samples an hour, 3 POCT machines would be necessary to maintain turnaround times. Conclusion: Even during ED high volume situations, POCT provided results significantly faster than in-laboratory testing.

关键词： Point-of-Care Testing Emergency Department Disaster Medicine

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