Kost Gerald J, Tran Nam K, Tuntideelert Masarus, Kulrattanamaneeporn Shayanisawa, Peungposop Narisara
POCT.CTR, Pathology and Laboratory Medicine, School of Medicine, University of California Davis, Davis, CA 95616, USA.
Am J Clin Pathol. 2006 Oct;126(4):513-20. doi: 10.1309/NWU5E6T0L4PFCBD9.
We assessed how point-of-care testing (POCT), diagnostic testing at or near the site of patient care, can optimize diagnosis, triage, and patient monitoring during disasters. We surveyed 4 primary care units (PCUs) and 10 hospitals in provinces hit hardest by the tsunami in Thailand and 22 hospitals in Katrina-affected areas. We assessed POCT, critical care testing, critical values notification, demographics, and disaster responses. Limited availability and poor organization severely limited POCT use. The tsunami impacted 48 PCUs plus island and province hospitals, which lacked adequate diagnostic instruments. Sudden overload of critical victims and transportation failures caused excessive mortality. In New Orleans, LA, flooding hindered rescue teams that could have been POCT-equipped. US sea, land, and airborne rescue brought POCT instruments closer to flooded areas. Katrina demonstrated POCT value in disaster responses. We recommend handheld POCT, airborne critical care testing, and disaster-specific mobile medical units in small-world networks worldwide.
我们评估了即时检验（POCT），即在患者护理现场或其附近进行的诊断检测，如何在灾难期间优化诊断、分诊和患者监测。我们调查了泰国受海啸影响最严重省份的4个基层医疗单位（PCU）和10家医院，以及卡特里娜飓风受灾地区的22家医院。我们评估了即时检验、重症监护检测、危急值报告、人口统计学和灾难应对情况。可用性有限和组织不善严重限制了即时检验的使用。海啸影响了48个基层医疗单位以及岛屿和省级医院，这些地方缺乏足够的诊断仪器。危急受害者的突然激增和运输故障导致了过高的死亡率。在路易斯安那州新奥尔良市，洪水阻碍了本可配备即时检验设备的救援队伍。美国的海上、陆地和空中救援行动将即时检验仪器带到了更靠近洪水区域的地方。卡特里娜飓风展现了即时检验在灾难应对中的价值。我们建议在全球小世界网络中采用手持式即时检验设备、空中重症监护检测以及针对特定灾难的移动医疗单位。
