Point-of-care testing (POCT) allows healthcare professionals to perform selected blood tests near the patient instead of sending every sample to a central laboratory. Portable devices such as the Abbott i-STAT 1 can deliver certain blood gas, electrolyte, and chemistry results in approximately two minutes, giving emergency teams quicker access to information that may help guide patient care.
What Is Point-of-Care Testing, and Why Does It Matter in Emergency Care?
Emergency departments are places where patients come to for emergent care. Some come in with breathing difficulties while others present with dehydration, chest pain, or electrolyte imbalance. Moreover, some require a laboratory workup before arriving at a definitive treatment plan.
Typically, blood tests are sent to a central laboratory for analysis. This is an integral part of a hospital’s operation. However, the samples require transportation, preparation, testing, and reporting before reaching the requesting physicians.
This is why point of care testing of Philippine hospitals is critical. By performing selected laboratory tests at the point of care, healthcare professionals can receive critical information closer to the patient, reducing overall wait time.
Where Does ER Blood Test Turnaround Time Go?
When assessing laboratory turnaround time in hospitals, many only consider the time it takes for a machine to process a blood sample. However, there are other steps involved before test results are available to the requesting physicians.
For instance, blood gas or electrolyte testing requires phlebotomy, transportation of the sample to the central laboratory, preparation and analysis by laboratory personnel, and reporting of results. Each of these steps adds to the overall turnaround time, with the laboratory analysis being only a component of the entire process.
A study published in the Academic Emergency Medicine journal in 2020 revealed that point of care testing resulted in a 28-minute average turnaround time, as opposed to 79 minutes for central laboratory testing. Although the difference was not great enough to impact overall emergency department length of stay, the results demonstrate the potential benefits of bedside testing.
What Blood Tests Can Be Performed at the Bedside?
One of the main advantages of point of care testing is the ability to perform a variety of blood tests with a single portable machine. For instance, the Abbott i-STAT Blood
Analyzer comes with disposable cartridges that can determine a range of physiological variables. As such, it can be used to facilitate selected laboratory investigations in the emergency department, intensive care units, and other approved settings.
The types of tests that can be performed with the i-STAT analyzer depend on the cartridge that is loaded into the machine.
Some of the laboratory tests that can be carried out with Abbott’s i-STAT analyzer include:
Blood Gas Testing
This includes measurement of the pH, partial pressure of oxygen and carbon dioxide. Blood gas analysis helps physicians determine if a patient has an acid-base imbalance and if they require oxygen supplementation. For hospitals considering a blood gas analyzer Philippines healthcare facilities can use at the bedside, considerations should be made regarding the device’s portability and overall turnaround time.
Electrolyte Testing
The i-STAT analyzer can help detect fluid imbalances by measuring sodium, potassium, and ionized calcium levels. This type of testing can be useful when managing patients who present with dehydration, renal disease, or electrolyte imbalance.
Blood Chemistry Testing
i-STAT’s cartridges can also be used to measure selected blood chemistry values, including glucose, creatinine, and blood urea nitrogen. These values can be used to determine a patient’s metabolic state and overall kidney function.
Hematocrit and Hemoglobin Testing
Certain i-STAT cartridges can be used to measure a patient’s hematocrit and calculate their hemoglobin level. This information can be crucial in facilitating fluid resuscitation and assisting healthcare professionals in managing selected patients’ conditions.
Cardiac Marker Testing
Selected i-STAT cartridges can be used to measure troponin levels as an aid in the diagnosis of myocardial infarction. Abbott’s high-sensitivity troponin I cartridge has an approximate processing time of 15 minutes, with the company stating that it is suitable for use in accordance with the intended application.
Not all tests have the same processing time, and the results of each test should be interpreted in the context of the patient’s presentation and the laboratory’s standard operating procedures. Additionally, healthcare facilities considering adopting point of care testing should confirm the availability, registration, and intended use of each test in their country before implementation.
How Does a Handheld Blood Analyzer Work?
A handheld blood analyzer enables healthcare professionals to perform selected laboratory tests at the point of care. The Abbott i-STAT analyzer works with disposable cartridges that have been approved for use with the machine. The process involves obtaining an appropriate blood sample, which is then placed in a cartridge according to the manufacturer’s instructions.
The cartridge is then inserted into the machine and analyzed. Most compatible blood gas and chemistry tests take approximately two minutes to produce results.
Although the process is relatively simple, it should be noted that appropriate specimen collection, operator training, and quality control are essential for reliable results. Additionally, it is the responsibility of a hospital’s laboratory to ensure appropriate oversight of point of care testing, including standardized operating procedures.
Is Point of Care Testing Accurate Enough?
While faster test results are always desirable, it is important to consider the accuracy of point of care testing. Generally, the Abbott i-STAT analyzer has been shown to provide reliable results for the tests it is intended for when operated by trained personnel. However, it should be noted that test results obtained with a handheld analyzer cannot always be directly substituted for those obtained in a central laboratory.
In order to ensure reliable point of care testing, hospitals must develop standardized operating procedures. This includes establishing appropriate training requirements for operating the machine, quality control testing, cartridge handling procedures, and result interpretation and validation guidelines.
Additionally, it is the responsibility of the hospital laboratory to ensure continued oversight of point of care testing, including documentation and appropriate adherence to operating standards. Overall, the objective should not be to sacrifice accuracy for the sake of speed, but rather to ensure reliable diagnostic information is available as soon as possible.
What Can Philippine Hospitals Learn from Turnaround Time Studies?
Reducing lab turnaround time in ER is an essential step towards improving the overall patient experience. As such, hospitals need to consider what contributes the most to laboratory wait time before implementing changes.
A study published in the BMC Emergency Medicine journal in 2018 demonstrated that selected emergency department patients benefited from faster test results and consequently, a reduced length of hospital stay.
However, it should be noted that while faster laboratory results can be beneficial, it is not the sole determining factor for a patient’s length of stay. Additionally, staffing levels, bed availability, availability of other diagnostic services such as imaging, and the overall complexity of the patient’s presenting problem can also play a role. As such, Philippine hospitals can benefit from analyzing their own operations in order to identify the most effective ways of reducing laboratory turnaround time.
How Can MEDTEK Help Philippine Hospitals With Bedside Testing?
When considering adopting a point of care testing system, hospitals need to identify what they hope to accomplish. It is important to recognize that while a handheld blood analyzer can provide faster results, it is not a substitute for a central laboratory. Hospitals should consider what laboratory tests they perform the most before adopting a point of care testing system.
Additionally, a hospital’s operating procedures will need to be adjusted in accordance with the new technology. For instance, a hospital’s laboratory will need to ensure appropriate personnel are trained and oversight is carried out before implementing bedside testing. It is also important to consider how the shortened turnaround time will affect other aspects of the hospital’s operation.
MEDTEK (Medical Trends and Technologies) is a leading distributor of medical equipment in the Philippines. We offer a wide variety of diagnostic products for Philippine hospitals, including the Abbott i-STAT handheld blood analyzer. By reviewing the MEDTEK i-STAT product catalog, hospital administrators can learn more about the machine’s capabilities and the types of tests that can be performed with it. Additionally, we encourage administrators to identify their needs before meeting with our laboratory specialists to discuss the benefits of bedside testing for their facility.
Frequently Asked Questions
What is the point of care testing?
Point of care testing enables trained healthcare professionals to perform selected laboratory tests closer to the patient, reducing overall wait time for results.
How quickly can Abbott i-STAT provide blood test results?
A variety of blood tests can be performed with the i-STAT analyzer. However, most compatible blood gas and chemistry tests take approximately two minutes to produce results.
Is point of care testing appropriate for emergency departments?
Yes. By allowing emergency doctors to obtain selected laboratory results at the point of care, valuable time can be saved when managing critically ill patients.
Who can perform point of care testing?
Point of care testing is intended for use by trained healthcare professionals. It can be performed in a variety of healthcare settings, including emergency departments, intensive care units, operating rooms, and other approved environments.
Can bedside blood testing replace a hospital’s central laboratory?
No. Although point of care testing can be useful in some situations, it is not meant to replace a central laboratory. Additionally, a hospital’s central laboratory offers a wider variety of tests as well as specialized services that are unavailable at the point of care.
Bring Faster Test Results Closer to Patient Care
In emergency care, time is of the essence. Point of care testing enables healthcare professionals to obtain the information they need without having to wait for a central laboratory to finish processing specimens.
As such, Philippine hospitals can benefit from adopting bedside testing in order to improve their overall emergency department workflow. It is important to remember, however, that while faster test results can be beneficial, they should not come at the expense of accuracy and precision.
Visit us at https://medtek.com.ph/ to learn more about the Abbott i-STAT Blood Analyzer and discuss your hospital’s testing needs and request an ER workflow demonstration.
For licensed and trained healthcare professionals. Product availability, intended uses, and Philippine regulatory requirements should be verified before procurement and clinical implementation.