![]() ![]() The glucose and INR devices lock out operators if quality controls are not run as specified and if someone that has not kept their competency tries to use the device. The INR POCT is primarily dedicated to patients that come in with a presentation concerning for stroke, while the use of glucose meters has many indications. The POCT glucose and INR devices are operated by nursing staff and a group of medical technologists facilitates regulatory compliance of the use of these devices, including performing linearities, comparisons, and competency training when needed. These POCT are overseen for regulatory requirements and operated by different groups. The ED has the following POCT available: glucose meters, international normalized ratio (INR) devices, urine pregnancy testing, blood gases, and troponin measurement. In our hospital the core laboratory is three buildings away and two floors up from the ED and it makes sense that bringing specimens over is problematic, even with a functional pneumatic tube system. In the following discussion we present how, in the same ED, certain POCT can work but others do not work at all. Thus, selected POCT can be of value if agreed upon turn-around times cannot be met. Both ED providers and laboratory directors are in agreement that short turn-around time of selected tests is better for patients. 3 For the ED, less than 1 hour was considered acceptable while above 2 hours was considered unacceptable. 1, 2 A survey of heads of biochemistry laboratories in the United Kingdom asked what was the optimal turn-around time for tests from receipt in the laboratory to results and what turn-around time they considered endangered patient safety. Publications from the Netherlands and the United States report that the number of tests ED providers seek to make decisions is limited Table 1. However, actual proof of decrease in ED length of stay with POCT use has been elusive. In their simulation model they show a potential decrease in ED length of stay from an average of 2.77 hours when a test is performed in 120 minutes to 2.17 hours if the test is performed in 10 minutes. ![]() Storrow et al 1 comment that POCT in ED has not been universally adopted even though easy-to-use instruments are widely available, analytical performance has improved, and various guidelines support their use. There is a general belief by clinicians that point-of-care testing (POCT) will allow more timely treatment of their patients, and one particular metric used to assess this is turn-around time for laboratory results and the impact on length of stay in the emergency department (ED). ![]()
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