However, inpatient LOS is not a typical reason for requesting ED-POCT. Of note, several studies did show decreased admissions 4, 7, 11, 13– 15, 19 and decreased hospital stays, § which could a priori reflect improved outcomes. Excluded references consisted of those that compared ED-POCT to central laboratory test characteristics or demonstrated new methodologies with hypothesized ED uses.Īs indicated in Tables 1 through 3, a variety of additional significant findings were identified on a case-by-case basis, but it was not clear if they actually improved patient outcomes. Inclusion of ED-LOS as a studied metric was not a requirement. For a reference to be included it had to be designed such that parameters were compared between POCT and non-POCT tested ED populations. References were then reviewed to select out those that studied changes in ED processes secondary to introduction of POCT.
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After the initial free text search, the PubMed “similar articles” function was used to identify related studies that avoided the searched free text terms. In addition, a vein of studies associated with POCT (but not described as “point of care”) was identified in the area of rapid infectious disease (predominantly influenza) testing. MATERIALS AND METHODSĪn English-language PubMed search was performed using the following free text terms: (“EMERGENCY” AND “POINT OF CARE”) NOT ULTRASOUND (there was a large number of studies regarding the use of ED point-of-care ultrasound). The purpose of this review was 3-fold (1) to compile the existing peer-reviewed ED POCT implementation literature (2) to describe how often POCT use resulted in significant changes to the management of the ED patient, especially ED-LOS and (3) to provide readers with a handy tool tracking what tests/conditions have been studied in the ED using POCT and how successful it was or not. 1, As with the inpatient experience, it is not clear if faster POCT results improve ED patient care management, leading to shortened ED-LOS, nor is it obvious how much data exist to support that claim and for what tests and/or disease conditions. 1, 2 Decreased ED-LOS per patient translates into faster patient throughput, less ED crowding, improved patient treatment, and overall better use of ED services. Emergency department (ED) POCT requests hypothesize that a rapid test result will not only speed up diagnosis, treatment, and management but will also necessarily and importantly lead to overall decreased ED length of stay (ED-LOS). However, whether or not POCT actually improves overall inpatient care has not yet been conclusively proven in the literature. Rapid test result turnaround time, that is, POCT, can and does improve care when a result is required for a time-sensitive clinical action, for example, blood glucose immediately prior to meals for appropriate timing and administration of insulin dose.
Hematocrit- aid in the determination and monitoring of normal or abnormal total red cell volume status that can be associated with conditions including anemia and erythrocytosis.Point-of-care test (POCT) instrument requests are typically predicated on the premise that faster results will a priori lead to better inpatient care secondary to quicker and targeted treatment. Glucose- used in the diagnosis, monitoring and treatment of carbohydrate metabolism disorders.īlood Urea Nitrogen (BUN)- aids in the diagnosis, monitoring and treatment of certain renal and metabolic disorders.
Ionized Calcium- aids in the diagnosis and treatment of parathyroid disease, bone disease, chronic renal disease and tetany. Potassium- monitoring and aiding in the diagnosis of diseases andĬlinical conditions that manifest high and low potassium levels.Ĭhloride- used in the diagnosis, monitoring, and treatment of electrolyte and metabolic disorders (e.g., cystic fibrosis, diabetic acidosis, and hydration disorders. Sodium- monitoring electrolyte imbalances. Panel includes: Sodium, Potassium, Chloride, Glucose, Urea Nitrogen, and Hematocrit. Performed at authorized locations by point of care operators.
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