Because measurements of GFR are tedious, estimated GFRs based on creatinine or cystatin C are widely used for assessing kidney function. Both measured GFRs and the Staging System for CKD based on GFR have analytical and clinical shortcomings. The advantages of serum creatinine and cystatin C, and eGFR will be...

This article explores the potential benefits of point-of-care testing in the ED. Price and St. John provide a detailed description on how to approach four common aspects of point-of-care testing (POCT) in the ED, specifically, the challenges of adopting POCT, the impact of POCT on clinical decisions, the impact of...

Neonates nearly always experience their single largest day of blood loss on the day of birth due to admission laboratory testing. The term "admission laboratory testing" refers to the initial blood tests done when a baby is born and admitted to the NICU.  Total circulating blood volume in a 3.5 kg term newborn is 280...

Chris Price and Andrew St John have followed their book Point-of-Care Testing for Managers and Policymakers with another look at the subject from strategic vision to change management and implementation in Point-of-Care Testing: Making Innovation Work for Patient-Centered Care. In their latest book the authors give...

When collecting blood for blood gas analysis, it is important to remove air bubbles from syringes to avoid erroneous results, especially for pO₂, with a number of factors affecting the potential magnitude of the interference to pO₂ by air bubbles.  In this study, we calculate the expected theoretical changes in pO₂...

Recent studies of D-dimer as a “rule-out” test for deep venous thrombosis (DVT) frequently have used duplex ultrasound rather than venography as the gold standard. Because duplex ultrasound has limited ability to image the calf veins, there is potential for ultrasound studies to classify patients with calf DVT as...

In most hospitals, the amount of nursing time spent on actual patient care is only 33 %, while problem solving consumes 40 % of their time. That’s the bad news. The good news is that inverting this ratio may be easier than you think.  According to Dr John Kenagy and David Sundahl of the US-based Kenagy & Associates,...

The National Kidney Disease Education Program (NKDEP) Laboratory Working Group reviewed problems related to serum creatinine measurement for estimating glomerular filtration rate (GFR) and prepared recommendations to standardize and improve creatinine measurement. The NKDEP recommends using the estimating equation...

Supported by Pennsylvania Hospital Kernicterus Fund and the Eglin Fund In the late 1980s, the question whether bilirubin damaged the brain of healthy infants was unanswered. The absence of documented evidence influenced the formulation of the 1994 consensus-based guidelines...

Optimizing all the steps in the testing cycle is as crucial to the success of point-of-care testing (POCT) as the measurement process itself. The complete POCT process or testing cycle is a complex series of events that involve many parties in any organization.  Consultation with all the people concerned is vital and ...