L9

• Point of care testing is also known as alternate site testing (AST) or ancillary, bedside, or near-patient testing
• POCT brings lab testing to the location of the patient.
• POCT made possible by advances in lab instrumentation that are small, portable, and often handheld testing devices.
• POCT allow HCP to address crucial patient needs, deliver prompt medical attention, and expedite patient recovery.
• Glucose Testing is one of the most common POCT procedure.
• Glucose Testing is done using glucometer
• glucometer is small, portable, and relatively inexpensive device that measures the amount of sugar in the blood
• Glucose Testing predominantly use whole blood specimen obtained by capillary puncture
• Glucose Testing used by diabetics to monitor their sugar
• Glucose Testing normal range: 100 to 140
• Materials for Glucose Testing

  • gloves
  • antiseptic pad or 70% alcohol
  • incision device (lancet, lancing pen)
  • glucometer
  • glucose strips
  • gauze pad
• Glucose testing procedure


  1. Identify the patient

  2. Explain the procedure

  3. Perform hand hygiene

  4. Apply gloves

  5. Prepare all materials

  6. Select the puncture site (3rd or 4th finger)

  7. Insert a glucose strip into the glucometer

  8. Puncture the finger using the lancing device

  9. Gently squeeze the finger until a drop of blood forms

  10. Position the meter beside the finger and use the strip to pick up the blood (do not touch the strip to the fingertip)

  11. Wipe the first drop

  12. Wait for the prompt of the device before withdrawing the finger

  13. Wait for the result

  14. Wipe the puncture site and apply pressure

  15. Record the results

  16. Dispose all materials

  17. Thank the patient
• Platelet function can help prevent excessive bleeding or blood clots especially before surgery.
• automated analyzer is a single-use, disposable assays that uses whole blood samples and gives measurements that correlate with laboratory testing.
• bleeding test is defined as the time required for a standardized skin wound to stop bleeding.
• bleeding time is a measurement of interaction between platelets and blood vessels.
• bleeding time look for the bleeding time to stop was recorded as the bleeding time result.
• bleeding time was technique-dependent and prone to error, and it has largely been replaced with other Platelet function studies.
• Bleeding Test (Duke's Method)

  1. identify the patient. explain the procedure. ask for previous medications.
  2. disinfect the puncture site.
  3. puncture the site. depth: 3mm
  4. start the timer as soon as the first flow of blood appears.
  5. blot the blood with the filter paper every 30 seconds. do not let the filter paper to touch the skin.
  6. use a different area of the filter paper when blotting.
  7. stop the timer when blood disappears or blood cannot be blotted.
  8. count the blood spots and divide by 2.
  9. dispose all materials. thank the patient.
• duke's method normal range is 1 to 5 minutes
• arterial blood gas is often ordered in emergency situations because of the critical balance in which these analytes must be maintained.
• arterial blood gas evaluate respiratory function and is used to determine the pH of blood, which threatens the patient's survival if it is outside the very narrow normal range.
• pH is an abbreviation for potential hydrogen, a scale representing relative acidity or alkalinity of a solution.
• arterial blood pH test is used to measure for body's acid-base balance and indicates metabolic and respiratory status.
• normal range for arterial blood pH is 7.35 to 7.45
• below normal is acidosis and above normal is alkalosis in pH
• pCO2 is a measure of the pressure exerted by dissolve CO2 in the blood plasma and is proportional to the pCO2 in the alveoli. It is an indicator of how well air is being exchanged between the blood and the lungs.
• pO2 is a measure of the pressure exerted by dissolved O2 in the blood plasma and indicates the ability of the lungs to diffuse O2 through the alveoli into the blood. It is used to evaluate the effectiveness of oxygen therapy.
• sO2 is a measurement of the percentage of hemoglobin binding sites occupied by oxygen in the bloodstream. It is used by physicians to determine a patient's oxygenation status.
• a syringe puncture is made to the arteries and specimen is placed in ice
• a normal, health individual with normal sO2 is above 95%
• pO2 (75 to 100 mm Hg)
• pCO2 (35 to 45 mm Hg)
• Special Collection

  1. blood bank specimens
  2. blood cultures
  3. coagulation specimens
  4. 2 hour postprandial glucose
  5. glucose tolerance test
  6. drug screening
• blood bank specimen requirements:

  • lavender or pink top EDTA tubes
  • non additive glass red-stoppered tube
  • require strict patient identification and specimen labeling procedures
  • special ID bracelet attached to patient's wrist might be used
  • blood bank specimen are encountered in blood transfusion, blood donation, and blood screening
• Standardized Blood Labeling

  A) ISBT 128 Blood Type Cod

  B) ABO or Rh Blood Group

  C) Expiration Date

  D) Special Testing Code

  E) ISBT Product Information

  F) ISBT 128 Product Code

  G) Facility Information

  H) ISBT 128 Donation Identification Number

  
• Blood typing determines a patient's blood type (ABO) and Rh factor (positive or negative)
• a cross-match is performed using the patient's type and screen results to help select a donor unit of blood before transfusion.
• the patient's plasma or serum and the donor's rbcs are mixed together to determine compatibility
• incompatible blood can be fatal