With the advancement of technology, it has become increasingly possible to conduct routine out-of-laboratory clinical research at a point of care with a reasonable level of accuracy. The main advantages offered by POCT devices are increased portability and speed. Using POCT, they can perform test results in a few minutes, and analyze, obtain and operate on them, much faster than when samples are sent to the central laboratory.
Because the * TAT * or sample return time and test response time for referrals to the Central Laboratory in most centers took more than 60 minutes, point-of-care (POCT) equipment is recommended. Use the care area.
If used effectively, * POCT * reduces the delay in starting treatment, increases ED efficiency, has a positive effect on patient care, and reduces the negative effects of overcrowding.
All cardiovascular organizations recommend that treatment for patients with the acute coronary syndrome (acute myocardial infarction and unstable angina) begin 30 to 60 minutes after admission to the emergency room. To achieve this goal in most centers, conventional laboratory systems are not responsive and the time required to achieve the diagnosis is much longer than the time required to test. Therefore, rapid cardiac enzyme measuring (POC) devices are installed in most emergency centers and even in laboratories and are used for rapid diagnosis of the acute coronary syndrome. Of course, these devices have been installed in laboratories due to their speed of operation and the use of whole blood instead of centrifuged samples.
Also, given the high cost of occupying a CCU bed, if the length of hospitalization for a patient suspected of having an acute myocardial infarction is only two days (which is usually more than this, of course) and minimal ancillary costs such as doctor visits, tests, photographs, serum And if we add the drug to it, we will reach a figure which, in any case, will not be comparable to the cost of performing all three tests (myoglobin, troponin and (CK-MB) by POC devices. However, it should be noted that In most cases of acute myocardial infarction, the diagnosis is made with only one or two tests and does not require all three tests.
Before using POC indicator devices and even after initial examinations and ECG,
75% of patients with chest pain still have no objective evidence of unstable coronary syndrome or AMI, and This causes the patient with AMI to be discharged from US emergency departments with misdiagnoses such as esophagitis, muscle strain, injury, neurological problems, or lung diseases such as bronchitis, COPD.
Among these patients who are discharged with a misdiagnosis, the mortality rate reaches 25%, which is twice the mortality rate of hospitalized patients, and the same misdiagnosis and treatment of acute myocardial infarction, 39% of the total fines for negligence. Assigns American doctors to the emergency room.
The above facts indicate the inadequacy of relying on the ECG and conventional methods in diagnosing or rejecting acute coronary syndrome and acute myocardial infarction AMI and wasting capital, time, and energy of the medical staff, Due to the widespread use of POC devices in cardiac markers in developed countries, the importance of using rapid biochemical markers (such as troponin, myoglobin, and CK-MB) in achieving early diagnosis and treatment of acute myocardial infarction AMI in emergency centers is increasingly known.
