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 situation...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.展开更多
Fluid optimization in the resuscitation of shock became the mainstay of treatment following the advent of Early Goal-Directed Therapy (EGDT) by Rivers et al. in 2001 [1]. Patients presenting in shock require prompt op...Fluid optimization in the resuscitation of shock became the mainstay of treatment following the advent of Early Goal-Directed Therapy (EGDT) by Rivers et al. in 2001 [1]. Patients presenting in shock require prompt optimization of volume status and cardiac out- put to ensure adequate perfusion. Poor optimization may be associated with prolonged hospital and intensive care unit stays. The prior gold standard, pulmonary artery catheterization, is rarely available in the emergency department setting and its invasive nature has led to recent re-evaluation of its clinical utility. However, there are new monitoring technologies that are being studied in the intensive care unit setting that may soon be available in emergency departments to aid in nursing and physician decision making to improve acute resuscitation.展开更多
文摘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.
文摘Fluid optimization in the resuscitation of shock became the mainstay of treatment following the advent of Early Goal-Directed Therapy (EGDT) by Rivers et al. in 2001 [1]. Patients presenting in shock require prompt optimization of volume status and cardiac out- put to ensure adequate perfusion. Poor optimization may be associated with prolonged hospital and intensive care unit stays. The prior gold standard, pulmonary artery catheterization, is rarely available in the emergency department setting and its invasive nature has led to recent re-evaluation of its clinical utility. However, there are new monitoring technologies that are being studied in the intensive care unit setting that may soon be available in emergency departments to aid in nursing and physician decision making to improve acute resuscitation.
