Point Of Care Testing Flashcards
Define POCT
Point of Care Testing is defined as a mode of medical testing in which the analysis is performed at the site where healthcare is provided close to the patient.
Other terms for POCT
“Near patient” testing
•“Bedside” testing
•“Physician office” testing
•“Ancillary” testing
•“Alternative site” testing
•“Extralaboratory” testing
•“Decentralised” testing
•“Off-site” testing
•“Unit-use” testing
Tests carried out as POCT
Blood glucose testing
•Blood gas and electrolyte analysis
•Rapid coagulation testing
•Rapid cardiac marker diagnostics
•Drug of abuse screening
•Urine strips testing
•Faecal occult blood analysis
•Food pathogens screening
•Haemoglobin diagnostics
•Infectious disease testing
•Cholesterol screening
Advantages of POCT
Fast Turn-Around time (TAT).
•Prompt, simplified and effective treatment of patient.
•Reduced administrative work associated with request for POCT
•Minimizes delay in sample collection, sample registration or preparation.
•Elimination of transportation cost time
•Result are promptly available for immediate and effective treatment or care of patients
•Important in remote villages or rural areas
•Allows for greater laboratory test selectivity.
Characteristics of a good POCT Analyzes
Portable instrument with consumable reagent cartridges
•A one or two step protocol
•Capability to perform direct specimen analysis on whole blood and urine.
•Simple operating procedure
•Flexible test menus
•Quantitative results with accuracy and precision compared to those of a central laboratory
•Integrated calibration and quality control
•Ambient temperature storage for reagents
Examples of POCT analyzers
Thermometers, Glucometers, Ph meters, dipsticks, sphygmomanometer, weighing balance and stethoscope to complex machines like a POCT Analyser or a POCT Device
Key component of POCT Analyzers
Operator interface/user interface
•Bar code identification reader
•Sample delivery device
•Reaction cell chamber
•Sensors
•Control and communication systems
•Data management and storage
•Manufacturing requirement
Types of POCT Devices
POCT devices are classified as:
•In vitro
•In vivo
•Ex vivo
•Minimally invasive
Limitations of POCT
The ready availability of tests may cause increased inappropriate testing
•The test may be performed by inexperienced, non-laboratory-trained staff
•Reference ranges and results may differ from those of the laboratory, thus making comparison difficult.
•Care is needed in machine maintenance and repairs.
•Poor training may lead to inadequate quality control.
•Lack of backup support should a device fail.
•Test may become expensive without economy of scale.
In vitro POCT is classified into
A. Single-use cartridge/strip test
B. Single-use quantitative cartridge/strip test with a monitoring device
C. Multiple-Use Cartridge and Bench-top system
Explain A. Single-use cartridge/strip test
•Single-pad urine test(dipstick)
•Complex strips that use light refluctance for measurement
•Fabricated cartridges that incorporates techniques such as immunochromatography(these are used as immunosensors)
Explain Single-use quantitative cartridge/strip test with a monitoring device
The availability of small, compact detectors is a result of advances in modern electronics and miniaturisation
•An integral part of many of these instruments is a charge-coupled device(CCD)
•Single-use devices for blood gas and other critical care measurements also available through optical sensors .
Explain Multiple-Use Cartridge and Bench-top system
Many of the POCT devices in this category are used for critical care testing in locations such as intensive care units, surgical suite and emergency room.
Invivo POCT
in-vivo devices, the sensing device is inserted into the blood stream e.g blood gas using optical technology
Ex vivo POCT
In ex-vivo, the sensing device or sensor are actually external to the body but in a closed loop of blood that leaves the body and is then returned downstream from the sensing device.
