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Blood Gas Analysis: The Pros and Cons of Point-Of-Care Testing

selected patient care settings, such as intensive care units (ICUs), operating rooms (ORs) and emergency departments. Because ABGs are the most common tests ordered in ORs and ICUs, immediate results are critical. Therefore, many health-care providers are choosing blood gas analysis that is performed via point-of-care testing (POCT), using handheld units that give a quick result at the bedside or operating table. Such handheld units can be used in non-traditional settings such as rural clinics and in ambulance or helicopter transport situations.

POCT can offer several benefits, most importantly the instant implementation of treatment decisions rather than waiting, sometimes for several hours, for the results from a more traditional central laboratory-based analyzer. By the time those results become available, the condition of the patient may have changed. In the case of POCT, immediate results mean immediate care. Specimen transport time is minimized as no staff have to leave the OR or bedside to carry a sample to the lab. In some cases, there may even be a reduction in pneumatic tube traffic. POCT also reduces the risk of preanalytical errors that may accompany traditional laboratory testing, such as the handling, labeling, and transport of samples.

Another advantage to POCT is a decrease in phlebotomy-related blood loss, an important feature in settings like the OR or ICU, where blood conservation is key. Some analyzers used in central laboratories have menus that require a minimum sample size, whereas POCT devices use smaller samples.

The reality of POCT, despite all of these benefits, is that the advantages of POCT are lost when a sample is mishandled or testing is done incorrectly. Therefore, implementation of point-of-care tests inherently demands structure and regulation (per JCAHO and CLIA regulation) to ensure quality results. POCT places a burden on department and site directors to properly identify the training needs of non-labora
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