Point of care (POC) testing is rapidly expanding. It can be defined as an analytical test undertaken in a setting distinct from a normal hospital laboratory; other synonyms include near patient testing, bedside testing and remote (as in, remote from a laboratory) testing. It encompasses a variety of testing media, ranging from single reagent strips to handheld electronic devices and bench-top analyzers, which may be used to test virtually any body fluid. This chapter concentrates on POC testing of blood samples only.
The concept of POC testing is not new; mediaeval medics relied on the observation of blood, urine and stool to assess the balance of humours (phlegmatic, choleric, sanguine and melancholic), in the presence of the patient (orvictim!). Althoughsome tests have continued to be carried out in this manner, the days of physicians counting red cells down the microscope have long gone.
Although pneumatic sample transportation systems and the automation of many clinical laboratory analytical methods have undoubtedly reduced the time from sampling to result (the ‘turn-around time’), the trend toward centralized services may, paradoxically, slow down receipt of results.
Despite the demand for rapid test results, particularly when it is perceived that these may dictate a change in or initiation of a new therapy, there is little evidence that this has any significant impact on clinical outcomes. Impact on overall running costs is also unknown.