The special value of POCT, a cardiac marker
Although the POCT formulation did not begin to emerge in the 1990s, in fact, in the 1970s, with the development of intensive care medicine, the need for POCT emerged. In coagulation tests, clinicians are very keen on rapid reporting and reliable results. The mean turnaround time (TAT) in laboratories is about 45-90 min at emergency or perioperative bleeding, and the time spent in a standardized laboratory is about POCT Long 1.5h. POCT and laboratory tests of coagulation, the specimen preparation and preparation methods are significantly different. POCT is easy to operate and provides quick results, so this need opens the door to the POCT application in the hemostatic assay. POCT assay does not require blood samples for examination, without waiting for the report, you can quickly adjust the dose to patients. The laboratory only telephoned the emergency and critical values, most of which were uploaded to the hospital information system and reviewed by the doctors themselves. The time saved by POCT can create some intangible value, especially in the custodial and operating rooms, the length of the operation, the amount of disposal, the time often meant savings in the cost of medical treatment and the reduction of unnecessary blood transfusions in the hemostatic thrombus test , Obvious advantages.
From the value of information, although most of the test results are quantitative indicators, clinical diagnosis often attributes to the nature of "yes" and "no", that is to say, what to do next, that is, clinical decision-making. Difficult to make decisions is not only the greatest harm to the patients, but also makes the doctors very helpless in the face of the patients in the afflictions. Without the need for specimen submission, testing is initially possible with clinical judgment, which will help clinicians to the greatest extent and demonstrates the value of testing in reducing the uncertainty of clinical decision-making.
When the value of POCT is ultimately reflected in its clinical relevance to disease diagnosis, management, and prognosis, our attitude towards POCT may become a requirement. For example, the international standardization ratio (INR) determination, INR reflects the weakened hemostasis, direct use of warfarin dose adjustment. POCT will be simple INR test freed from the cumbersome procedures in the hospital operation, reducing the waiting time for laboratory reports, but also shorten the cycle to inform patients to adjust the dose, which greatly facilitates the patient's medical treatment, but also under the premise of quality control, To ensure drug safety, with significant social benefits. If INR is not urgent enough, then it is important to assess the APTT for intraoperative bleeding monitoring and overall coagulation assessment, and POCT's bedside facilities provide a very fluid and consistent clinical procedure that is loved by specialists. However, hematologists tend to rely on traditional indicators and POCT is not considered an effective tool for accurate assessment of hemostasis; some medical examiners also have concerns about the use of POCT in clinical settings; this limits their widespread use to some extent.
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