Technology has reduced the blood-filled central clinical laboratory into a compact self-contained testing device located within arm’s reach of critically ill patients. Point of care testing deploys a wide array of arterial gas and blood chemistry systems to the bedside, and creates a new challenge for healthcare technology management. Planning, education and record-keeping make the difference.

photoTechnology has transformed the central clinical laboratory from a dynamic hub where blood-filled test tubes are transported for analysis, to a compact self-contained testing device within steps of a critically ill patient’s bedside.

POCT (Point of Care Testing) devices range in size from slightly larger than a palmtop personal digital organizer to typical PC monitor dimensions. Often deployed in intensive care settings, the original machines were used for blood gas analysis where the world of STAT resides. These days, a wider array of blood chemistry and other studies are possible within an arm’s reach of the clinician and patient involved.

In the plus column
Think NICU babies. Too little oxygen in the bloodstream and there is an increased risk of brain damage. Too much, and the infant could lose valuable sight. This tightrope requires immediate blood gas results.

Greg Duncan, CBET, assistant chief engineer and manager of biomedical engineering at Children’s Hospital Oakland (Calif.) described the use of i-STAT System devices in their intensive care units.

“Two of my biomeds have a strong respiratory background, so they spend a good part of their time in the ICN,” said Duncan. “From a biomed service standpoint, if we’re getting inaccurate or questionable readings, we run a few checks to make sure there is not operator error, and call up i-STAT. If we can’t solve the problem, we box it up and they have a new one here the next day.”

The i-STAT system consists of a hand-held microprocessor-based analyzer and test cartridges that contain an array of biosensors microfabricated onto silicon chips. i-STAT Corporation (East Windsor, N.J.) entered a strategic marketing and sales alliance with Abbott Diagnostics in 1998.

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