Point-of-care testing: an expanding repertoire in accident and emergency

Accident and emergency (A&E) departments across the UK are experiencing increasing pressure to turnaround patients more quickly as a result of the government’s introduction of national waiting times.¹ Early identification and prioritisation of patients treated in A&E is important for medical safety and quality. The goal is to provide the highest safety level in emergency treatment triage and to reduce processing times for diagnostics, decisions and interventions in A&E.²

Quality and efficiency of emergency care depends directly on timely laboratory results, were the role of laboratory medicine in the diagnostic process is as high as 70%.³ Point-of-care testing (POCT) devices can be used to reduce the turnaround time (TAT) for therapy-critical parameters. The effects are numerous and include reduction in patient waiting time before start of treatment with a direct impact on diagnosis, and an A&E with POCT needs less monitoring capacity. Additionally, improved diagnosis and treatment decisions relieve pressure on the intensive care unit (ICU), cardiac care unit (CCU) and intermediate care departments.

             The A&E department at St Mary’s Hospital on the Isle of Wight serves a population of about 140,000 permanent island residents, with numbers rising to about a million during the summer with the influx of holiday-makers.⁴ Approximately 70,000 patients range from neonates to octogenarians attend the A&E each year with a wide range of medical conditions. The A&E has a one front door policy which makes its economic and medical functionality of particular importance. About 90% of patients who are eventually hospitalised are initially assessed in the A&E.⁵