![]() Most previous studies evaluating POCT in the emergency department (ED) have used a small number of POCT devices and laboratory tests that are shared among a large number of patients and nurses, often limited to specific clinical conditions and laboratory tests. Vein-to-brain times by eliminating most of the pre- and postanalytical delays because once a test result is complete, the physician is immediately able to act upon the result. Department of Emergency Medicine, HSC L4-080, 8350 SUNY, Stony Brook, NY 11794-8350. ? Disclosures: AJS is on the Speaker’s Bureau of Abbot Point of Care. Bedside point-of-care testing (POCT) using portable yet accurate devices has the potential to significantly reduce The time from ordering and obtaining a blood sample until the practitioner is aware of the test results and can act upon them is often referred to as the “vein-to-brain” time. Although the time required to analyze blood samples once they reach the central laboratory has improved dramatically and may be short, preanalytical and postanalytical delays, which are outside the control of the central laboratory, may be considerable. Often, a major barrier to early diagnosis is the delay associated with central laboratory testing. Early diagnosis and aggressive therapy are especially important in criti- cally ill or injured patients with time-sensitive conditions such as myo- cardial infarction, stroke, sepsis, and major trauma. According to a report by the prestigious Institute of Medicine, the two important components of high-quality care are the provision of timely and effective care. ED LOS was also reduced in the latter population.ĭuring the last decade, there has been an increased emphasis on the delivery of high-quality and patient-centered care. 03).Ĭonclusions: Introduction of comprehensive bedside POCT in critical ED patients is associated with significant reductions in test turnaround, and time to completion of CT scanning when IV contrast is required. Point-of-care testing significantly reduced median ED LOS in patients who received an IV contrast CT (260 vs 347 P =. Use of POCT reduced the median time to completion of IV contrast CT by 81 minutes (96 vs 177 P =. Test turnaround (minutes) was significantly reduced with bedside POCT for all five tests. Results: The numbers of critical ED patients before and after introducing POCT were 1405 and 981 respectively. Clinical protocols indicated when POCT should be used. During the before pe- riod, traditional lab testing was performed, whereas in the after period, bedside POCT devices were introduced in all 15 critical care beds with 5 testing cartridges (chemistry with hemoglobin and hematocrit, troponin I, brain natriuretic peptide, lactate, and international normalized ratio ). Methods: A before and after study was performed in ED patients triaged to the critical care area. We hypothesized that POCT would shorten ED length of stay (LOS), reduce time to test results, and reduce time to completion of intravenous (IV) contrast computed tomography (CT) imaging compared with central lab testing. ![]() Objective: We determined the effects of comprehensive point-of-care testing (POCT) on process of care in critically ill emergency department (ED) patients. ![]()
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