Point of Care: Diagnostics in Hemostasisthe Wrong Direction?

2003 ◽  
Vol 9 (3) ◽  
pp. 191-195 ◽  
Author(s):  
Thomas W. Stief ◽  
Jawed Fareed
Keyword(s):  
Point Of Care ◽  
Blood Gases ◽  
Small Samples ◽  
Central Laboratory ◽  
Medical Decisions ◽  
Point Of Care Diagnostics ◽  
Wrong Direction ◽  
Rapid Transport ◽  
Hospital Wards ◽  
Laboratory Assay

Point-of-care-testing (POCT) is performance of a laboratory assay outside the laboratory by nontrained personnel. The advantages of POCT are: more rapid medical decisions, avoidance of long sample transports, and small samples. The disadvantages of POCT are: no laboratory personnel, insufficient calibration, quality control and maintenance, poor documentation, high costs, difficult comparability POCT/central laboratory. Therefore, disposing of a 24-hour central laboratory, the POCT spectrum should be limited to the vital parameters: K+, Ca++, Na+, glucose, creatinine, blood gases, hemoglobin or hematocrit, NH3, lactate. POCT offers no advantages, if the hospital has a rapid transport system such as a pneumatic delivery to the central laboratory. The rapid diagnosis of the acute hemostasis state of a patient should be performed in the 24-hour central laboratory that is connected to all hospital wards via a good pneumatic delivery.

scholarly journals Can a Point-of-Care Troponin I Assay be as Good as a Central Laboratory Assay? A MIDAS Investigation

2016 ◽  
Vol 36 (5) ◽  
pp. 405-412 ◽  
Author(s):  
W. Frank Peacock ◽  
Deborah Diercks ◽  
Robert Birkhahn ◽  
Adam J. Singer ◽  
Judd E. Hollander ◽  
...  
Keyword(s):  
Troponin I ◽  
Point Of Care ◽  
Central Laboratory ◽  
Laboratory Assay

Comparison of Point-of-Care versus Central Laboratory Testing of Electrolytes, Hemoglobin, and Bilirubin in Neonates

2021 ◽  
Author(s):  
Ha-young Choi ◽  
William Corder ◽  
Eshetu Tefera ◽  
Kabir M. Abubakar
Keyword(s):  
Point Of Care ◽  
Blood Gases ◽  
Clinical Judgments ◽  
Central Laboratory ◽  
Concordance Correlation ◽  
Sodium Potassium ◽  
Paired Samples ◽  
Key Points ◽  
The Mean ◽  
Small Blood Volume

Objective Electrolyte, hemoglobin, and bilirubin values are routinely reported with point-of-care (POC) testing for blood gases. Results are rapidly available and require a small blood volume. Yet, these results are underutilized due to noted discrepancies between central laboratory (CL) and POC testing. The study aimed to determine the correlation between POC and CL measurement of electrolytes, hemoglobin, and bilirubin in neonates. Study Design Electrolyte, hemoglobin, and bilirubin results obtained from capillary blood over a 4-month period were analyzed. Each CL value was matched with a POC value from the same sample or another sample less than 1-hour apart. Agreement was determined by measuring the mean difference (MD) between paired samples with 95% limits of agreement (LOA) and Lin's concordance correlation (LCC). Results There were 355-paired sodium/potassium, 139 paired hemoglobin, and 197 paired bilirubin values analyzed. POC sodium values were lower (133.5 ± 5.8 mmol/L) than CL (140.2 ± 5.8 mmol/L), p <0.00001 with poor agreement (LCC = 0.49; MD = 6.7; 95% LOA: −13.6 to 0.14). POC potassium values were lower (4.6 ± 0.98 mmol/L) than CL (4.98 ± 1.24mEq/L), p < 0.0001, but with better concordance and agreement. (LCC = 0.6; MD = 0.4; 95% LOA: −2.3 to 1.4). There were no differences in hemoglobin between POC (14.3 ± 3.2 g/dL) and CL (14.4 ± 3.1 g/dL), p = 0.2 with good LCC (0.93) and in bilirubin values between POC (6.0 ± 3.2 mg/dL) and CL (5.8 ± 3.0 mg/dL), MD = 0.18, and p = 0.07. Conclusion POC Sodium values are lower than CL. POC potassium levels are also lower, but the differences may not be clinically important while hemoglobin and bilirubin levels are similar between POC and CL. As POC potassium, hemoglobin, and bilirubin levels closely reflect CL values, these results can be relied upon to make clinical judgments in neonates. Key Points

scholarly journals COVID-19 Point-of-Care Diagnostics: Present and Future

ACS Nano ◽  
2021 ◽  
Author(s):  
Enrique Valera ◽  
Aaron Jankelow ◽  
Jongwon Lim ◽  
Victoria Kindratenko ◽  
Anurup Ganguli ◽  
...  
Keyword(s):  
Point Of Care ◽  
Point Of Care Diagnostics

scholarly journals 145 Point of care lung ultrasound in patient triage: integration of ultrasound into a streaming pathway for COVID-19

2020 ◽  
Vol 37 (12) ◽  
pp. 839.1-839
Author(s):  
Dominic Craver ◽  
Aminah Ahmad ◽  
Anna Colclough
Keyword(s):  
Point Of Care ◽  
District General Hospital ◽  
Training Programme ◽  
Service Evaluation ◽  
University Hospital ◽  
Junior Doctors ◽  
Point Of Care Ultrasound ◽  
Face To Face ◽  
Point Of Care Diagnostics ◽  
Audit Data

Aims/Objectives/BackgroundRapid risk stratification of patients is vital for Emergency Department (ED) streaming during the COVID-19 pandemic. Ideally, patients should be split into red (suspected/confirmed COVID-19) and green (non COVID-19) zones in order to minimise the risk of patient-to-patient and patient-to-staff transmission. A robust yet rapid streaming system combining clinician impression with point-of-care diagnostics is therefore necessary.Point of care ultrasound (POCUS) findings in COVID-19 have been shown to correlate well with computed tomography (CT) findings, and it therefore has value as a front-door diagnostic tool. At University Hospital Lewisham (a district general hospital in south London), we recognised the value of early POCUS and its potential for use in patient streaming.Methods/DesignWe developed a training programme, ‘POCUS for COVID’ and subsequently integrated POCUS into streaming of our ED patients. The training involved Zoom lectures, a face to face practical, a 10 scan sign off process followed by a final triggered assessment. Patient outcomes were reviewed in conjunction with their scan reports.Results/ConclusionsCurrently, we have 21 ED junior doctors performing ultrasound scans independently, and all patients presenting to our department are scanned either in triage or in the ambulance. A combination of clinical judgement and scan findings are used to stream the patient to an appropriate area.Service evaluation with analysis of audit data has found our streaming to be 94% sensitive and 79% specific as an indicator of COVID 19. Further analysis is ongoing.Here we present both the structure of our training programme and our integrated streaming pathway along with preliminary analysis results.

scholarly journals Point of Care Diagnostics in the Age of COVID-19

Diagnostics ◽  
2020 ◽  
Vol 11 (1) ◽  
pp. 9
Author(s):  
Meysam Rezaei ◽  
Sajad Razavi Bazaz ◽  
Sareh Zhand ◽  
Nima Sayyadi ◽  
Dayong Jin ◽  
...  
Keyword(s):  
Point Of Care ◽  
Diagnostic Methods ◽  
Global Public Health ◽  
Current Standard ◽  
Healthcare Facilities ◽  
Major Threat ◽  
Point Of Care Diagnostics ◽  
Recent Outbreak ◽  
Control Virus ◽  
Biosafety Level

The recent outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its associated serious respiratory disease, coronavirus disease 2019 (COVID-19), poses a major threat to global public health. Owing to the lack of vaccine and effective treatments, many countries have been overwhelmed with an exponential spread of the virus and surge in the number of confirmed COVID-19 cases. Current standard diagnostic methods are inadequate for widespread testing as they suffer from prolonged turn-around times (>12 h) and mostly rely on high-biosafety-level laboratories and well-trained technicians. Point-of-care (POC) tests have the potential to vastly improve healthcare in several ways, ranging from enabling earlier detection and easier monitoring of disease to reaching remote populations. In recent years, the field of POC diagnostics has improved markedly with the advent of micro- and nanotechnologies. Due to the COVID-19 pandemic, POC technologies have been rapidly innovated to address key limitations faced in existing standard diagnostic methods. This review summarizes and compares the latest available POC immunoassay, nucleic acid-based and clustered regularly interspaced short palindromic repeats- (CRISPR)-mediated tests for SARS-CoV-2 detection that we anticipate aiding healthcare facilities to control virus infection and prevent subsequent spread.

scholarly journals Pocket MUSE: an affordable, versatile and high-performance fluorescence microscope using a smartphone

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Yehe Liu ◽  
Andrew M. Rollins ◽  
Richard M. Levenson ◽  
Farzad Fereidouni ◽  
Michael W. Jenkins
Keyword(s):  
High Performance ◽  
Point Of Care ◽  
Low Cost ◽  
Consumer Electronics ◽  
Practical Implementation ◽  
The Novel ◽  
Point Of Care Diagnostics ◽  
Optical Module ◽  
Optical Configuration ◽  
User Friendly

AbstractSmartphone microscopes can be useful tools for a broad range of imaging applications. This manuscript demonstrates the first practical implementation of Microscopy with Ultraviolet Surface Excitation (MUSE) in a compact smartphone microscope called Pocket MUSE, resulting in a remarkably effective design. Fabricated with parts from consumer electronics that are readily available at low cost, the small optical module attaches directly over the rear lens in a smartphone. It enables high-quality multichannel fluorescence microscopy with submicron resolution over a 10× equivalent field of view. In addition to the novel optical configuration, Pocket MUSE is compatible with a series of simple, portable, and user-friendly sample preparation strategies that can be directly implemented for various microscopy applications for point-of-care diagnostics, at-home health monitoring, plant biology, STEM education, environmental studies, etc.

scholarly journals Microfluidics-Based Plasmonic Biosensing System Based on Patterned Plasmonic Nanostructure Arrays

Micromachines ◽  
2021 ◽  
Vol 12 (7) ◽  
pp. 826
Author(s):  
Yanting Liu ◽  
Xuming Zhang
Keyword(s):  
Plasmon Resonance ◽  
Point Of Care ◽  
Simultaneous Detection ◽  
High Sensitivity ◽  
Microfluidic Chips ◽  
Label Free ◽  
Plasmonic Nanostructure ◽  
Point Of Care Diagnostics ◽  
Surface Enhanced Raman ◽  
Nanostructure Arrays

This review aims to summarize the recent advances and progress of plasmonic biosensors based on patterned plasmonic nanostructure arrays that are integrated with microfluidic chips for various biomedical detection applications. The plasmonic biosensors have made rapid progress in miniaturization sensors with greatly enhanced performance through the continuous advances in plasmon resonance techniques such as surface plasmon resonance (SPR) and localized SPR (LSPR)-based refractive index sensing, SPR imaging (SPRi), and surface-enhanced Raman scattering (SERS). Meanwhile, microfluidic integration promotes multiplexing opportunities for the plasmonic biosensors in the simultaneous detection of multiple analytes. Particularly, different types of microfluidic-integrated plasmonic biosensor systems based on versatile patterned plasmonic nanostructured arrays were reviewed comprehensively, including their methods and relevant typical works. The microfluidics-based plasmonic biosensors provide a high-throughput platform for the biochemical molecular analysis with the advantages such as ultra-high sensitivity, label-free, and real time performance; thus, they continue to benefit the existing and emerging applications of biomedical studies, chemical analyses, and point-of-care diagnostics.

scholarly journals Triboelectric Effect Enabled Self-Powered, Point-of-Care Diagnostics: Opportunities for Developing ASSURED and REASSURED Devices

Micromachines ◽  
2021 ◽  
Vol 12 (3) ◽  
pp. 337
Author(s):  
Navneet Soin ◽  
Sam J. Fishlock ◽  
Colin Kelsey ◽  
Suzanne Smith
Keyword(s):  
High Efficiency ◽  
Resource Constraints ◽  
Point Of Care ◽  
Wearable Sensors ◽  
Middle Income ◽  
Physiological Signal ◽  
Point Of Care Diagnostics ◽  
Self Powered ◽  
Triboelectric Nanogenerators ◽  
Triboelectric Effect

The use of rapid point-of-care (PoC) diagnostics in conjunction with physiological signal monitoring has seen tremendous progress in their availability and uptake, particularly in low- and middle-income countries (LMICs). However, to truly overcome infrastructural and resource constraints, there is an urgent need for self-powered devices which can enable on-demand and/or continuous monitoring of patients. The past decade has seen the rapid rise of triboelectric nanogenerators (TENGs) as the choice for high-efficiency energy harvesting for developing self-powered systems as well as for use as sensors. This review provides an overview of the current state of the art of such wearable sensors and end-to-end solutions for physiological and biomarker monitoring. We further discuss the current constraints and bottlenecks of these devices and systems and provide an outlook on the development of TENG-enabled PoC/monitoring devices that could eventually meet criteria formulated specifically for use in LMICs.

Sign in / Sign up

Export Citation Format

Share Document