POINT OF CARE TESTING
Lecture 6
DEFINITION

Medical testing at or near the site of patient care.

It is a mode of analysis which is performed at the site where the
health care is provided close to the patient.

Bed side, near patient, physician’s office, extra laboratory, off
site, unit used testing.
ADVANTAGES

Reduced turnaround time (TAT).

Improved health outcomes.

Rapid data availability.

Self contained and user friendly instruments.

Small sample volume for large test menu.

Ability to test many types of samples.
DISADVANTAGES
Bedside tests performed by poorly trained nonlaboratorian.
 Cost of POCT compared with traditional laboratory
testing.
 Quality of testing is operator dependent.
 Narrower measuring range for some of the analytes.

CHARACTERISTICS OF POCT DEVICES
First result in minutes or less.
 Portable instruments with consumable reagent
cartridges.
 A one or two step operating protocol.
 The capability of performing direct specimen analysis
on whole blood and urine.
 Simple procedure that do not require laboratory
trained operator.

CHARACTERISTICS OF POCT
DEVICES

Built in/ integrated calibration and quality
control.

Results provided as hard copy, stored and
available for transmission.

Low instrument cost.

Built in regulatory record keeping.

Temperature storage for reagents.
POINT OF CARE TESTING MIGHT BE
EMPLOYED
Primary care
Home
 Community pharmacist
 Health centers (general practice)
 Workplace clinic
 Physician’s office
 Paramedical support vehicle (ambulance,
helicopter, air craft )

SECONDARY AND TERTIARY CARE
Emergency room
Admission unit
Operating room
Intensive care unit
Wards
Outpatient clinics
TYPES OF DEVICES USED FOR POCT
Single use qualitative or semi-quantitative
cartridge strip test
 Single use quantitative cartridge/ strip test with
a reader device
 Multiple use quantitative cartridge/bench top
devices

SINGLE USE QUALITATIVE OR SEMIQUANTITATIVE CARTRIDGE STRIP
TEST

Urine chemistry

Blood chemistry

Infectious disease agents

Cardiac markers

hCG
SINGLE USE QUANTITATIVE
CARTRIDGE/ STRIP TEST WITH A
READER DEVICE
Glucose
 Blood chemistry
 Coagulation
 Cardiac markers
 Drugs
 CRP
 Allergy
 Fertility testing

pH
 HbA1c
 Blood gases
 Electrolytes

MULTIPLE USE QUANTITATIVE
CARTRIDGE/BENCH TOP DEVICES

pH

Blood gases

Electrolytes

Metabolites

Complete blood count

Bilirubin

Cardiac marker

CRP
POCT DEVICES AVAILABLE IN THE
HOSPITALS
Blood gases, electrolytes, lactate
 Cardiac biomarkers, renal markers, Bilirubin
 Cholesterol, triglyceride and HDL
 Intra-operative PTH measurement
 Blood glucose (includes self-testing devices)
 Alcohol and toxicology (paracetamol, drugs of
abuse)
 Urinalysis(with or without a reader)

POCT DEVICES AVAILABLE IN THE
HOSPITALS
Haemoglobin A1c
 Albumin
 Anticoagulant therapy monitoring (includes selftesting devices)
 Detection of pregnancy and ovulation (includes
self-testing devices)
 Infections(Chlamydia, HIV)
 Stool occult blood

POCT DEVICES AVAILABLE IN
COMMUNITY SETTING
Blood glucose (includes self-testing devices)
 Urinalysis(with or without a reader)
 Cholesterol, triglyceride and HDL
 Anticoagulant therapy monitoring (includes selftesting devices)
 Detection of pregnancy and ovulation (includes
self-testing devices)

CARDIAC MARKERS

The American Heart Association has recommended a
turnaround time for cardiac markers of 60 minutes.

Tests of POCT should be compatible to the results of the
central laboratory.

Improved diagnosis

Shortened emergency department length of stay

Decreasing patient time in the emergency department by
45 minutes.
GLUCOSE MONITORING
PROGRAMME

First glucometer was introduced by “Bayer” in
1969.

Old standard is the laboratory based test.

Glucometer give the rapid and relatively precise
glucose estimation on whole blood at the patients
bedside.
Frequent blood glucose monitoring allows better
glycemic control in hospital as well as at home.
 Reduced morbidity and mortality associated with
glycemic control.

LIMITATIONS
POCT glucose is slightly higher than
venous blood.
 This difference is significant in case of
postprandial specimen.
 Other interferences include hematocrit,
po2, temperature and humidity.
 Use of POCT not recommended in
shock, dibetic coma and dehydartion.
