Abstract
Point-of-care-testing (POCT) facilitates rapid availability of results that allows prompt clinical decision making. These results must be reliable and the whole process must not compromise its quality. Blood gas analyzers are one of the most used methods for POCT tests in Emergency Departments (ED) and in critical patients. Whole blood is the preferred sample, and we must be aware that hemolysis can occur. These devices cannot detect the presence of hemolysis in the sample, and because of the characteristics of the sample, we cannot visually detect it either. Hemolysis can alter the result of different parameters, including potassium with abnormal high results or masking low levels (hypokalemia) when reporting normal concentrations. Severe hyperkalemia is associated with the risk of potentially fatal cardiac arrhythmia and demands emergency clinical intervention. Hemolysis can be considered the most frequent cause of pseudohyperkalemia (spurious hyperkalemia) or pseudonormokalemia and can be accompanied by a wrong diagnosis and an ensuing inappropriate clinical decision making. A complete review of the potential causes of falsely elevated potassium concentrations in blood is presented in this article. POCT programs properly led and organized by the clinical laboratory can help to prevent errors and their impact on patient care.
Highlights
Based on Price’s and Hicks’ definition point-of-care-testing (POCT) are those assays of blood and other body fluids orThe rapid availability of results that allows prompt clinical decision-making is the main reason for using POCT and avoids the need to send specimens to a central laboratory facility
Results for POCT need to be reliable to contribute to better patient care
The healthcare professional running these tests does not need to be qualified in laboratory disciplines, but they must be adequately trained and certified by laboratory professional that must supervise this critical part of the POCT process
Summary
Based on Price’s and Hicks’ definition point-of-care-testing (POCT) are those assays of blood and other body fluids or. An adverse device event is any incident in which the use of medical equipment may have resulted in an adverse outcome for the patient. When considering medical errors in clinical laboratory testing, are mostly failures of planned testing actions. These include POCT [4]. In a study of stat test errors published by Plebani et al, of 189 cliniciandiscovered errors, they found that three quarters of them (140 [70%]) did not affect patient’s outcome, but that about a fifth (37 [19.6%]) were associated with inappropriate investigations resulting in an unjustifiable increase in costs, and that one in 16 (12 [6.3%]) led to inappropriate care or inappropriate modification of therapy [5]. Most of them have been recognized in the preanalytic phase as occurs with errors in the stat laboratory where some
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