Point-of-care testing in emergency medical systems

Point-of-care testing (POCT) refers to clinical laboratory testing performed at or near the site of care. Since the development of small and battery-powered portable laboratory analyzers, POCT has also become part of diagnostic management in pre-hospital emergency medicine. Although only few controlled studies have been conducted to date, experience and conclusions from its implementation in emergency departments and critical care units indicate its feasibility and relevance as an additional diagnostic tool in the pre-hospital setting. Depending on availability, POCT is currently used in the field for blood gas analysis, measurement of electrolytes (sodium, potassium, chloride and calcium), hemoglobin, lactate and markers of cardiac ischemia (cardiac troponin T and troponin I, myoglobin and creatine kinase-MB). The development of new parameters, especially for the detection of cardiac ischemia, should lead to further improvements within the next few years.