PMID- 29887410 OWN - NLM STAT- MEDLINE DCOM- 20190107 LR - 20190107 IS - 0736-4679 (Print) IS - 0736-4679 (Linking) VI - 55 IP - 2 DP - 2018 Aug TI - Early Point-of-Care Testing at Triage Reduces Care Time in Stable Adult Emergency Department Patients. PG - 172-178 LID - S0736-4679(18)30489-X [pii] LID - 10.1016/j.jemermed.2018.04.061 [doi] AB - BACKGROUND: Core laboratory testing may increase length of stay and delay care. OBJECTIVES: We compared length of emergency department (ED) care in patients receiving point-of-care testing (POCT) at triage vs. traditional core laboratory testing. METHODS: We conducted a prospective, case-controlled trial of adult patients with prespecified conditions requiring laboratory testing and had POCT performed by a nurse after triage for: a basic metabolic panel, troponin I, lactate, INR (i-STAT System), urinalysis (Beckman Coulter Icon), or urine pregnancy test. Study patients were matched with controls based on clinical condition, gender, age, and time to be seen. Groups were compared with Wilcoxon rank-sum or Fisher's exact tests. RESULTS: We matched 52 POCT study patients with 52 controls. Groups were similar in age, gender, clinical condition, time to be seen by a physician (3.3 h, 95% confidence interval [CI] 2.2-4.4, vs. 3.1 h, 95% CI 2.2-4.5 h, in POCT and control patients, respectively; p = 0.84), use of imaging, and disposition. Of 52 study patients, 3 (5.8%, 95% CI 2.0-15.9) were immediately transferred to the critical care area to be urgently seen by an emergency physician. POCT patients had a significantly shorter median (interquartile range [IQR]) ED care time than matched controls (7.6, 95% CI 5.1-9.5 vs. 8.5, 6.2-11.3 h, respectively; p = 0.015). Median [IQR] ED length of stay was similar in study patients and controls (9.6, 95% CI 7.9-14.5 vs. 12.5, 8.2-21.2 h, respectively; p = 0.15). CONCLUSIONS: Among stable adult patients presenting to the ED with one of the prespecified conditions, early POCT at triage, compared with traditional core laboratory testing after evaluation by an ED provider, reduced ED care time by approximately 1 h. CI - Copyright (c) 2018 Elsevier Inc. All rights reserved. FAU - Singer, Adam J AU - Singer AJ AD - Department of Emergency Medicine, Stony Brook University, Stony Brook, New York. FAU - Taylor, Merry AU - Taylor M AD - Department of Emergency Medicine, Stony Brook University, Stony Brook, New York. FAU - LeBlanc, Deborah AU - LeBlanc D AD - Department of Emergency Medicine, Stony Brook University, Stony Brook, New York. FAU - Meyers, Kristen AU - Meyers K AD - Department of Emergency Medicine, Stony Brook University, Stony Brook, New York. FAU - Perez, Karol AU - Perez K AD - Department of Emergency Medicine, Stony Brook University, Stony Brook, New York. FAU - Thode, Henry C Jr AU - Thode HC Jr AD - Department of Emergency Medicine, Stony Brook University, Stony Brook, New York. FAU - Pines, Jesse M AU - Pines JM AD - Department of Emergency Medicine, George Washington University, Washington, DC. LA - eng PT - Journal Article PT - Observational Study DEP - 20180607 PL - United States TA - J Emerg Med JT - The Journal of emergency medicine JID - 8412174 SB - IM MH - Adult MH - Aged MH - Emergency Service, Hospital/organization & administration MH - Female MH - Humans MH - Length of Stay/*statistics & numerical data MH - Male MH - Middle Aged MH - Point-of-Care Testing MH - Prospective Studies MH - *Time Factors MH - Triage/methods/*standards/statistics & numerical data OTO - NOTNLM OT - emergency department OT - length of stay OT - point-of-care testing OT - triage EDAT- 2018/06/12 06:00 MHDA- 2019/01/08 06:00 CRDT- 2018/06/12 06:00 PHST- 2018/02/27 00:00 [received] PHST- 2018/04/20 00:00 [revised] PHST- 2018/04/27 00:00 [accepted] PHST- 2018/06/12 06:00 [pubmed] PHST- 2019/01/08 06:00 [medline] PHST- 2018/06/12 06:00 [entrez] AID - S0736-4679(18)30489-X [pii] AID - 10.1016/j.jemermed.2018.04.061 [doi] PST - ppublish SO - J Emerg Med. 2018 Aug;55(2):172-178. doi: 10.1016/j.jemermed.2018.04.061. Epub 2018 Jun 7.