Chapter 17

• POCT is also known as alternate site testing.
• Most tests performed as POCT are tests waived by the CLIA ’88, Such tests are called CLIA-waived.
• Hgb is the most common hematology test performed as a POC test.
• Hemoglobin testing is used to diagnose and monitor anemia.
• A simple, fast method of anemia testing uses a handheld-hemoglobin-analyzer.
• g/dL - which can be tracked over the disease course or be used to determine the response to therapy.
• Hct - Results are available within 2 minutes.
• Hct reading is sometimes made at the bedside or, more commonly, in the clinic office.
• Coagulation monitoring is used to monitor patients with clotting disorders who are receiving therapy.
• Coaglation - Most give results in 5 minutes or less
• Heparin therapy may be monitored by determining the activated coagulation time.
• ACT - A small volume of blood is collected in a prewarmed tube

  that contains a coagulation activator.
• An automated-ACT-tester is available for HT.
• APTT can also be used to monitor heparin therapy.
• Oral anticoagulant therapy using warfarin - Coumadin
• Coumadin is monitored by the PT test.
• Antiplatelet medications, which are used to prevent stroke.
• Antiplatelet medications, include aspirin-and-clopidogrel, may also require monitoring for their effect on coagulation.
• Bedside-glucose-monitoring is the most common chemistry test done by POCT.
• Glucose is determined with dermal-puncture-and-reagent-strips
• GLCOSE - The specimen tested is whole blood.
• The ancillary blood glucose test is performed at the bedside, most often for patients with diabetes-mellitus
• Proper-calibration-and-control are critical for accurate results - GLCOSE
• Hemoglobin-A1c can be analyzed as a CLIA-waived test, using a handheld portable testing monitor.
• MultiTest-A1c-System - These devices are designed for clinics and physicians’ offices to manage patients with diabetes.
• Hemoglobin-A1C - The test monitors the long-term effectiveness

  of diabetes therapy by providing a reading of A1c.
• A1c, a protein related to the average blood glucose level over a period of 4-to-6 weeks.
• Cardiac-troponin-T is part of a protein complex in cardiac muscle that aids the interaction of actin and myosin.
• Damaged cardiac muscle releases cardiac TnT.
• the plasma level of cardiac TnT rises within 4 hours after an acute myocardial infarction.
• Values that are well outside the range of normal - panic-values
• Cardian TnT - It may stay elevated for up to 2 weeks, and its level may help determine the extent of damage and the patient’s prognosis.
• Therefore monitoring cardiac TnT can provide valuable information

  for a patient with a possible myocardial-infarction.
• Cardiac TnT - Bedside determination is performed using anticoagulated-wholeblood.
• Cardian TnT - results are available within 15 minutes
• Some POCT determinations use a one-step, disposable-color-card test rather than a machine.
• arterial blood gases - the concentrations of oxygen and carbon dioxide and the pH.
• Blood Gases and Electrolytes - They are particularly useful when frequent or rapid chemistry determinations must be made.
• B-type natriuretic peptide also known as brain natriuretic peptide.
• BNP - is a hormone made by the heart in response to expansion of ventricular volume and pressure overload