seminar POCT

Defined by College of American Pathologists (CAP) as:

“Those analytical patient-testing activities provided ____________________ the physical facilities of

the clinical laboratories.

Defined by College of American Pathologists (CAP) as:

“Those analytical patient-testing activities provided within the

institution, but performed outside the physical facilities of

the clinical laboratories.

ASSURED meaning

a - affordable

s - sensitive

s - specific

u - user friendly

r - robust and rapid

e - equipment free

d - deliverable to those who need the test

is home health care a place of analysis for POCT

YES

KEY COMPONENTS OF POCT?

1.) Operator Interface

2.) Barcode identification system

3.) Sample types and Sample delivery

4.) Reaction cell

5.) Sensors

6.) Control and communication systems

7.) Data management and storage.

Requires minimal operator interaction

operator interface

Guide the user through the operation

operator interface

Indicate whether any key steps have failed

operator interface

Allow identification of the operator, patient and the test to be

measured.

operator interface

what are the type of operator interface used?

keypads, barcode readers, printers and touch screens

Identifying the reagent package to the system-single use or

multiuse reagent pack.

barcode

Incorporating calibration data

barcode

Programming the instrument to process particular test or

group of tests.

barcode

Whole blood or urine specimens

sample

Collection tube can be directly inserted into the POCT

instrument.

sample

examples. of sample types and delivery?

strip, casette, cartridge, or fluidic cell

Analytical reactions takes place in simple porous pad to

microfluidic cartridge.

reaction cell

true or false?

in reaction cell, as analytical reactions have become more complex, less

reaction cell or zones need to be added.

false - more reaction cell (directly proportion)

in reaction cell, there should be ________ of samples and reagents

proper mixing !!

type of sensor which one where the analyte has an intrinsic

property, such as electrochemical that enables it to be

detected without a recognition element.

chemosensor

type of sensor which has a biological or biological

component as the recognition element

biosensor

commonly used recognition element

enzymes and antibodies

__ is crucial to POCT devices may include internal quality

control results, computing and reporting the patient results.

IT

Data transfer and management takes place when the meter

or reader is linked to a small bench top device called as

__________

DOCKING STATION

But nowadays _____________ is used for data

transfer and communication.

wireless communication

DISPOSABLE HAND-HELD DEVICES

1. ___ or ___ dipsticks

2. _____ and _____ strips together with accompanying

meters

3. Lateral flow devices including ______

4. _____ or cassette devices

1. Urine or blood dipsticks

2. Glucose and coagulation strips together with accompanying

meters

3. Lateral flow devices including immunosensors

4. Cartridge or cassette devices

in urine or blood dipstick, ________ is a semipermeable membrane that

prevents red cells from entering the matrix

uppermost

Biosensors in that they all use an enzyme as the

recognition agent.

glucose strips and meters

one of the largest sectors

of the POCT market

coagulation monitoring

The reaction usually takes place in a cassette or test

strip that is maintained at a temperature above 37 °C

coagulation strips and meters

in coagulation strips and meters, Measurement of prothrombin time (PT) clotting is detected by ________.

impedance

(coagulation strips and meters)

o Test strip has _________—one for → _____ test

o ___ for → different concentrations of internal QC reference

materials

o All three channels operate ________ when a patient

sample is applied to the strip

o Test strip has three channels—one for → patient test

o Two for → different concentrations of internal QC reference

materials

o All three channels operate simultaneously when a patient

sample is applied to the strip

what are the problems in coagulation strips and meters

• One problem is the poor correlation between POCT devices

and coagulation analyzers in the central laboratory

• Problem for activated clotting time (ACT)

in lateral flow strips, what step is when whole blood is added to the test well, it flows through the fleece, separating the plasma, and the troponin binds to the two antibodies

step 2

in lateral flow strips, what step is Binds to the Biotin in the troponin complex, immobilizing itb and appearing as a purple band due to the presence of gold particles on one of the antibodies (Ab)

step 4

Step 1 Two antibodies are present in the strip

(1) One labelled with _____

(2) Other conjugated to _____

Step 2 When whole blood is added to the test well, it flows through

the ____, separating the plasma, and the _____ binds

to the __ antibodies

Step 3 The ___________ flows along the

__________ and reaches the _________, w/c

contains ________

Step 4 Binds to the _______ in the ________, immobilizing

it and appearing as a ________ due to the presence of

__________ on one of the antibodies (Ab)

Step 5 _____ gold-labeled antibody is able to to move down

the strip. It is captured by a ________ that contains the

epitope of human cardiac _______, w/c is visualized

as a separate second band

Step 1 Two antibodies are present in the strip

(1) One labelled with gold particles

(2) Other conjugated to biotin

Step 2 When whole blood is added to the test well, it flows through

the fleece, separating the plasma, and the troponin binds

to the two antibodies

Step 3 The antibody-troponin complex flows along the

cellulose nitrate strip and reaches the capture zone, w/c

contains streptavidin

Step 4 Binds to the Biotin in the troponin complex, immobilizing

it and appearing as a purple band due to the presence of

gold particles on one of the antibodies (Ab)

Step 5 Unreacted gold-labeled antibody is able to move down

the strip. It is captured by a synthetic peptide that contains the

epitope of human cardiac Troponin T, w/c is visualized

as a separate second band

To perform CBCs using analytical principles

similar to those used with laboratory-based

devices

bench top devices

To provide full white cell differentiation

bench top

bench top devices uses _______________________ for detection

dry coated reagents and time-resolved fluorescence

one step immunofluorometric assay

troponin

what are the analytes measured?

1. C-reactive Protein (CRP)

2. Human chorionic gonadotropin (Hcg)

3. Troponin

4. Analytes/Electrolytes

- HbA1c – Light Scattering Immunoassay

- Lipid and Urinary Albumin

Multiple-Use Cartridges and Benchtop Systems used in?

ICU, surgical suite, ER

Thick film sensors or electrodes in strips to measure (5)

1) Glucose

2) Lactate

3) Urea

4) Blood gases

5) Electrolytes

true or false

Multiple-Use Cartridges and Benchtop Systems, the sensors are designed to be manageable

false - reusable

Multiple-Use Cartridges and Benchtop Systems

true or false

The sensors have been incorporated w/ reagents and

calibrators into a double cartridge or pack that is placed in the

body of a small to medium-sized, portable critical care

analyzer.

false - single cartridge

primary duty of POCT

patient care :))

extensive or minimal?

POCT knows laboratory setting

minimal

extensive or minimal?

POCT understands instruments quality checks

minimal

what need is delivery of results rapidly to the place

where it is needed

clinical need

what need is reduced complexity in the process of

obtaining a test result.

process need