Assessing Point-of-Care Device Specifications and Needs for Pathogen Detection in Emergencies and Disasters

Kost, Gerald J.; Mecozzi, Daniel M.; Brock, T. Keith; Curtis, Corbin M.

doi:10.1097/poc.0b013e31825a25cb

Cited by 11 publications

(15 citation statements)

References 23 publications

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“…While portable nucleic acid detection instruments are not yet commercially available for multiplex pathogen detection (but under development in the Center), tactics to fulfill needs have been established by analyzing surveys of disaster experts, POC users, and laboratory professionals (Figure 7), 9–12 who identified risk areas (e.g., MRSA, cholera, and Dengue fever) where current diagnostic tools are deemed inadequate for crises in light of the fact that conventional hospital infrastructure could be compromised and microbiology laboratories inoperable or inaccessible. Besides detecting highly ranked pathogens, helping conserve drugs in short supply, and determining epidemiological patterns of drug resistance, survey respondents stated that POC devices should be fast (<1 hour analysis time), highly specific (>90%), handheld, and capable of retaining biohazards.…”

Section: Results: Evidence-based Tacticsmentioning

confidence: 99%

“…Besides detecting highly ranked pathogens, helping conserve drugs in short supply, and determining epidemiological patterns of drug resistance, survey respondents stated that POC devices should be fast (<1 hour analysis time), highly specific (>90%), handheld, and capable of retaining biohazards. 9–12 …”

Section: Results: Evidence-based Tacticsmentioning

confidence: 99%

“…Pathogen detection devices should have form factors recommended by needs assessment surveys. 9–12 For example, biohazards must be contained and test cassettes should be disposable without risk of instrument contamination.…”

Section: Discussionmentioning

confidence: 99%

“…Needs assessment surveys 9–12 documented the presence of input gaps (left side, Figure 1) which, in the case of pathogen detection, were: a) lack of an appropriate preanalytical solution because exposed whole-blood samples often become contaminated, b) deficient transportable multiplex testing, and c) no definitive POC solution suitable for crises, despite the fact that survey respondents recognized the need for rapid diagnosis of infectious diseases, tracking of pandemics, and other urgencies. Then, working through the flowchart provides rational guidance for developing new POC test clusters that work well in emergencies and disasters.…”

Section: Methods: Anticipatory Strategiesmentioning

confidence: 99%

“…Frames A, B, and C display results for pathogen priorities in disaster settings from three surveys: A) editorial board members of two disaster journals (n=19), 10 B) readership of Point of Care (POC) (n= 47), 11 and C) members of the American Association of Clinical Chemistry (AACC) (n=100), 12 respectively. Frames D, E, and F display results of high priority pathogens for bloodstream infection testing from the same groups: D) editorial board members (n=21), E) POC (n=49), and F) AACC (n=83).…”

Section: Figurementioning

confidence: 99%

See 4 more Smart Citations

Enhancing crisis standards of care using innovative point-of-care testing

Kost¹,

Sakaguchi²,

Curtis³

et al. 2011

Am J Disaster Med

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Objective To identify strategies with tactics that enable point-of-care (POC) testing (medical testing at or near the site of care) to improve outcomes effectively in emergencies, disasters, and public health crises, especially where community infrastructure is compromised. Design Logic model-critical path-feedback identified needs for improving practices. Reverse stress analysis showed POC should be integrated, responders properly trained, and devices staged in small-world networks (SWNs). We summarize first responder POC resources, strategize test clusters, address assay environmental vulnerabilities, and design tactics useful for SWNs, alternate care facilities, shelters, point-of-distribution centers, and community hospitals. Participants and Environment Emergency-disaster needs assessment survey respondents and Center experience. Outcomes Important tactics are: a) develop training/education courses and “just-in-time” on-line web resources to assure the competency of POC coordinators and high quality testing performance; b) protect equipment from environmental extremes by sealing reagents, controlling temperature and humidity to which they are exposed, and establishing near-patient testing in defined environments that operate within current FDA licensing claims (illustrated with HIV-1/2 tests); c) position testing in defined sites within SWNs and other environments; d) harden POC devices and reagents to withstand wider ranges of environmental extremes in field applications; e) promote new POC technologies for pathogen detection and other assays, per needs assessment results; and f) select tests according to mission objectives and value propositions. Conclusions Careful implementation of POC testing will facilitate evidence-based triage, diagnosis, treatment, and monitoring of victims and patients, while advancing standards of care in emergencies and disasters, as well as public health crises.

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Section: Results: Evidence-based Tacticsmentioning

confidence: 99%

Section: Results: Evidence-based Tacticsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methods: Anticipatory Strategiesmentioning

confidence: 99%

Section: Figurementioning

confidence: 99%

See 3 more Smart Citations

Enhancing crisis standards of care using innovative point-of-care testing

Kost¹,

Sakaguchi²,

Curtis³

et al. 2011

Am J Disaster Med

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AACC Guidance Document on Management of Point-of-Care Testing

Nichols

Alter

Isbell

et al. 2020

The Journal of Applied Laboratory Medicine

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Strategic Point-of-Care Requirements of Hospitals and Public Health for Preparedness in Regions at Risk

Kost

Katip

Curtis

2012

Point of Care: The Journal of Near-Patient Testing &Amp; Technology

Self Cite

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Objectives To study health resources and point-of-care (POC) testing requirements for urgent, emergency, and disaster care in Phang Nga Province, Thailand; to determine instrument design specifications through a direct needs assessment survey; to describe POC test menus useful in the small-world network; and to assess strategies for preparedness following the 2004 Tsunami. Methods We surveyed medical professionals in community hospitals, a regional hospital, and the Naval Base Hospital; and officials at the offices of Provincial Public Health and Disaster Prevention and Mitigation. Questions covered: a) demographics and test requirements, b) POC needs, c) device design specifications, and d) pathogen detection options. Respondents scored choices. Scores determined priorities. Results Respondents selected complete blood count, electrolytes/chemistry, blood type, oxygen saturation (by pulse oximeter), hematocrit, and microbiology as top priorities, and preferred direct blood sampling with cassettes. Cardiac biomarkers were important in alternate care facilities. Staphylococcus aureus, SARS, Streptococcus pneumoniae, and hepatitis B were top infectious disease problems. Temperature, vibration, humidity, and impact shock were four important environmental conditions during extreme conditions. Conclusions Point-of-care testing can be used on a daily basis for competency and efficiency. Familiarity improves preparedness. Instrument designs must anticipate user preferences and environment stresses. The results show how a region at risk can adapt its small-world network. Point-of-care testing has become an important risk-reducing modality for crises and works equally well in low-resource settings to speed the delivery of routine and urgent care.

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Assessing Point-of-Care Device Specifications and Needs for Pathogen Detection in Emergencies and Disasters

Cited by 11 publications

References 23 publications

Enhancing crisis standards of care using innovative point-of-care testing

Enhancing crisis standards of care using innovative point-of-care testing

AACC Guidance Document on Management of Point-of-Care Testing

Strategic Point-of-Care Requirements of Hospitals and Public Health for Preparedness in Regions at Risk

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