From the Guidelines
The most appropriate point-of-care (POC) lab tests to order for a patient include a complete blood count (CBC) with differential leukocyte count and platelet count, measurement of serum levels of creatinine and blood urea nitrogen, and measurement of electrolytes, hepatic transaminase enzymes, and total bilirubin, as recommended by the Infectious Diseases Society of America 1. When selecting POC tests, it is essential to consider the patient's clinical presentation, suspected diagnosis, and care setting.
- Common essential POC tests include glucose monitoring, basic metabolic panel, cardiac markers (troponin, BNP), coagulation studies (PT/INR), urinalysis, pregnancy testing, and blood gases.
- For acute presentations, prioritize tests that guide immediate management decisions, such as glucose for altered mental status, troponin for chest pain, or lactate for suspected sepsis.
- In primary care settings, hemoglobin A1c, lipid panels, and rapid strep or influenza testing are valuable. The clinical context should always guide test selection, as unnecessary testing increases costs and may lead to further unnecessary interventions, as noted in the clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the Infectious Diseases Society of America 1. It is crucial to prioritize tests that have a high sensitivity and specificity, a high pre-test probability of the condition, and will significantly impact immediate management, as recommended by the Infectious Diseases Society of America 1.
From the Research
Point-of-Care Lab Testing
The most appropriate point-of-care (POC) lab tests to order for a patient depend on various factors, including the patient's condition, symptoms, and medical history.
- POC tests can range from basic blood-glucose measurement to complex viscoelastic coagulation assays 2.
- Recent technological advances have enabled the development of novel POC instruments, which can provide rapid and accurate test results at the point of care 3.
Common POC Lab Tests
Some common POC lab tests include:
- Influenza tests, which can help diagnose and manage influenza infections 4, 5.
- Drug of abuse tests, which can help combat the opioid epidemic 6.
- Blood-glucose tests, which can help manage diabetes.
- Coagulation assays, which can help diagnose and manage bleeding disorders.
Benefits and Limitations of POC Lab Tests
POC lab tests have several benefits, including:
- Rapid test results, which can help shorten the time to clinical decision-making 2.
- Convenience and accessibility, which can improve patient outcomes and reduce healthcare costs 3. However, POC lab tests also have some limitations, including:
- Lower accuracy and reliability compared to traditional laboratory tests 3.
- Quality control and connectivity issues, which can affect test results 3.
- Higher costs per individual test, which can increase healthcare costs 3.