Impact of Cardiac Point-of-care Testing on ED Door to Disposition Time is Dependent on Patient Acuity and Hospital Setting

<sec id="s1">Introduction: Recognising acute traumatic coagulopathy (ATC) poses a significant challenge to improving survival in emergency care. Paramedics are in a prime position to identify ATC in pre-hospital major trauma and initiate appropriate coagulopathy management. </sec> <sec id="s2">Method: A database literature review was conducted using Scopus, CINAHL and MEDLINE. </sec> <sec id="s3">Results: Two themes were identified from four studies: prediction tools, and point-of-care testing. Prediction tools identified key common ATC markers in the pre-hospital setting, including: systolic blood pressure, reduced Glasgow Coma Score and trauma to the chest, abdomen and pelvis. Point-of-care testing was found to have limited value. </sec> <sec id="s4">Conclusion: Future research needs to explore paramedics using prediction tools in identifying ATC, which could alert hospitals to prepare for blood products for damage control resuscitation. </sec>

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Point-of-Care Testing in the Private Hospital Setting in Thailand

Point of Care The Journal of Near-Patient Testing & Technology ◽

10.1097/00134384-200312000-00007 ◽

2003 ◽

Vol 2 (4) ◽

pp. 262-264

Author(s):

Supannee Akaraeaktharin ◽

Navapun Charuruks

Keyword(s):

Private Hospital ◽

Point Of Care ◽

Hospital Setting ◽

Point Of Care Testing

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Development of a Web-based Contact Tracing and Point-of-Care-Testing Workflow for SARS-CoV-2 at a German University Hospital

10.21203/rs.3.rs-379502/v1 ◽

2021 ◽

Author(s):

Julian Zirbes ◽

Christian M Sterr ◽

Marcus Steller ◽

Laura I Dapper ◽

Claudia I Nonnenmacher-Winter ◽

...

Keyword(s):

Infection Control ◽

Point Of Care ◽

Health Sector ◽

Hospital Setting ◽

Physical Distance ◽

University Hospital ◽

Contact Tracing ◽

Point Of Care Testing ◽

Web Based ◽

Symptomatic Disease

Abstract Introduction: In late 2019, a novel coronavirus was detected in China. Supported by its respiratory transmissibility, even by people infected without symptomatic disease, this coronavirus soon began to rapidly spread worldwide. Background: Many countries have implemented different infection control and containment strategies due to ongoing community transmission. In this context, contact tracing as well as adequate testing and consequent quarantining of high-risk contacts play leading roles in containing the virus by interrupting infection chains. This approach is especially important in the hospital setting where contacts often cannot be avoided and physical distance is usually not possible. Furthermore, health care workers (HCWs) usually have contact with a variety of vulnerable people, making it essential to identify infections among hospital employees as soon as possible to interrupt the rapid spread of SARS-CoV-2 in the facility. Several electronic tools for contact tracing, such as specific software or mobile phone apps, are available for the public health sector. In contrast, contact tracing in hospitals often has to be carried out without helpful electronic tools, and an enormous amount of human resources is typically required. Aim: For rapid contact tracing and effective infection control and management measures for HCWs in hospitals, adapted technical solutions are needed.Methods: In this study, we report the development of our containment strategy to a web-based contact tracing and rapid point-of-care-testing workflow.Results/Conclusion: Our workflow yielded efficient control of the rapidly evolving situation during the SARS-CoV-2 pandemic from May 2020 until January 2021 at a German University Hospital.

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Point-of-Care Testing in Out-of-Hospital Cardiac Arrest: A Retrospective Analysis of Relevance and Consequences

10.21203/rs.3.rs-489129/v1 ◽

2021 ◽

Author(s):

Tobias Gruebl ◽

Birgit Ploeger ◽

Erich Wranze-Bielefeld ◽

Markus Mueller ◽

Willi Schmidbauer ◽

...

Keyword(s):

Cardiac Arrest ◽

Treatment Time ◽

Point Of Care ◽

Venous Blood ◽

Hospital Setting ◽

Hospital Treatment ◽

Point Of Care Testing ◽

Study Region ◽

Probability Of Survival ◽

Arterial Blood

Abstract BackgroundMetabolic and electrolyte imbalances are some of the reversible causes of cardiac arrest and can be diagnosed even in the pre-hospital setting with a mobile analyser for point-of-care testing (POCT).MethodsWe conducted a retrospective observational study, which included analysing all pre-hospital resuscitations in the study region between October 2015 and December 2016. A mobile POCT analyser (Alere epoc®) was available at the scene of each resuscitation. We analysed the frequency of use of POCT, the incidence of pathological findings, the specific interventions based on POCT as well as every patient’s eventual outcome.ResultsN=263 pre-hospital resuscitations were included and in n=98 of them, the POCT analyser was used. Of these measurements, 64% were performed using venous blood and 36% using arterial blood. The results of POCT showed that 63% of tested patients had severe metabolic acidosis (pH<7.2+BE<-5mmol/l). Of these patients, 82% received buffering treatment with sodium bicarbonate. Potassium levels were markedly divergent normal (>6.0mmol/l / <2.5mmol/l) in 17% of tested patients and 14% of them received a potassium infusion. On average, the pre-hospital treatment time between arrival of the first emergency medical responders and the beginning of transport was 54 (+/- 20) min without POCT and 60 (+/- 17) min with POCT (p=0.07). Overall, 21% of patients survived to hospital discharge (POCT 30% vs no POCT 16%, p=0.01).Conclusions Using a POCT analyser in pre-hospital resuscitation allows rapid detection of pathological acid-base imbalances and potassium concentrations and often leads to specific interventions on scene and could improve the probability of survival.

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Comparison of International Normalized Ratio Measurement between CoaguChek XS Plus and STA-R Coagulation Analyzers

BioMed Research International ◽

10.1155/2013/213109 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6 ◽

Cited By ~ 9

Author(s):

Mina Hur ◽

Hanah Kim ◽

Chul Min Park ◽

Antonio La Gioia ◽

Sang-Gyu Choi ◽

...

Keyword(s):

Point Of Care ◽

Hospital Setting ◽

International Normalized Ratio ◽

Excellent Correlation ◽

Point Of Care Testing ◽

Altman Plot ◽

Ratio Measurement ◽

The Mean ◽

Coaguchek Xs ◽

Roche Diagnostics

Background. Point-of-care testing (POCT) coagulometers are increasingly being used in the hospital setting. We investigated whether the prothrombin time international normalized ratio (INR) results by CoaguChek XS Plus (Roche Diagnostics GmbH, Mannheim, Germany) can be used reliably without being confirmed with the INR results by STA-R system (Diagnostica Stago S.A.S, Asnières sur Seine, France).Methods. A total of 118 INR measurements by CoaguChek XS Plus and STA-R were compared using Passing/Bablok regression analysis and Bland-Altman plot. Agreement of the INR measurements was further assessed in relation to dosing decision.Results. The correlation of INR measurements between CoaguChek XS Plus and STA-R was excellent (correlation coefficient = 0.964). The mean difference tended to increase as INR results increased and was 0.25 INR in the therapeutic range (2.0-3.0 INR). The overall agreement was fair to good (kappa = 0.679), and 21/118 (17.8%) INR measurements showed a difference in dosing decision.Conclusion. The positive bias of CoaguChek XS Plus may be obvious even in the therapeutic INR range, and dosing decision based on the CoaguChek XS Plus INR results would be different from that based on the STA-R results. The INR measurements by POCT coagulometers still need to be confirmed with the laboratory INR measurements.

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Point-of-care testing in out-of-hospital cardiac arrest: a retrospective analysis of relevance and consequences

Scandinavian Journal of Trauma Resuscitation and Emergency Medicine ◽

10.1186/s13049-021-00943-w ◽

2021 ◽

Vol 29 (1) ◽

Author(s):

Tobias Gruebl ◽

B. Ploeger ◽

E. Wranze-Bielefeld ◽

M. Mueller ◽

W. Schmidbauer ◽

...

Keyword(s):

Cardiac Arrest ◽

Treatment Time ◽

Point Of Care ◽

Venous Blood ◽

Hospital Setting ◽

Hospital Treatment ◽

Point Of Care Testing ◽

Study Region ◽

Probability Of Survival ◽

Arterial Blood

Abstract Background Metabolic and electrolyte imbalances are some of the reversible causes of cardiac arrest and can be diagnosed even in the pre-hospital setting with a mobile analyser for point-of-care testing (POCT). Methods We conducted a retrospective observational study, which included analysing all pre-hospital resuscitations in the study region between October 2015 and December 2016. A mobile POCT analyser (Alere epoc®) was available at the scene of each resuscitation. We analysed the frequency of use of POCT, the incidence of pathological findings, the specific interventions based on POCT as well as every patient’s eventual outcome. Results N = 263 pre-hospital resuscitations were included and in n = 98 of them, the POCT analyser was used. Of these measurements, 64% were performed using venous blood and 36% using arterial blood. The results of POCT showed that 63% of tested patients had severe metabolic acidosis (pH < 7.2 + BE < − 5 mmol/l). Of these patients, 82% received buffering treatment with sodium bicarbonate. Potassium levels were markedly divergent normal (> 6.0 mmol/l/ < 2.5 mmol/l) in 17% of tested patients and 14% of them received a potassium infusion. On average, the pre-hospital treatment time between arrival of the first emergency medical responders and the beginning of transport was 54 (± 20) min without POCT and 60 (± 17) min with POCT (p = 0.07). Overall, 21% of patients survived to hospital discharge (POCT 30% vs no POCT 16%, p = 0.01, Φ = 0.16). Conclusions Using a POCT analyser in pre-hospital resuscitation allows rapid detection of pathological acid–base imbalances and potassium concentrations and often leads to specific interventions on scene and could improve the probability of survival.

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