The Rural Point of Care Testing Service (R-POCT) is now operational in all rural general practices across both Auckland DHB and Waitemata DHB areas.
Providing Point of Care Testing (POCT) in rural general practices enables rapid decision-making from assessment and diagnostics to treatment. It also minimises unnecessary emergency department presentations and/or hospitalisations, and facilitates the provision of appropriate care at the right time, in the right place (whether that is at the patient’s general practice or by referral to hospital).
Using the services stocktake, the Rural Alliance identified the 4 most clinically valuable POCT tests for the management of people presenting acutely unwell in a rural setting. The service uses the POCT analysers to provide rapid results to assist clinical diagnosis either by ruling out conditions, confirming conditions or determining whether further investigations are needed, i.e. enabling the right management to be initiated sooner. The following R-POCT tests are now carried out by the rural practices:
a) Troponin I (Trop I) on the i-STAT Analyser
A blood test to detect troponin, a protein found in heart muscle and released into the blood when there is damage to the heart. This is the preferred test for a suspected heart attack because it is more specific for heart injuries than other tests, and the marker rises within two to six hours of myocardial injury. Serial testing is required.
b) D-Dimer on the H232 Analyser
A blood test used to rule out active blood clot formation for DVT (deep vein thrombosis) and PE (pulmonary embolism). This test is also used to confirm whether additional testing may be needed to see if a blood clot exists.
c) International Normalised Ratio (INR) on the i-STAT Analyser
A blood test that checks how long it takes for blood to clot via the extrinsic pathway. The higher the INR, the longer it will take for blood to clot and the higher the risk of bleeding. Primarily used for patients taking warfarin who present acutely unwell to ensure that they are not at risk of bleeding.
d) Full Blood Count (FBC) on the QBC STAR Analyser
Used as a broad screening test to check for conditions such as sepsis, anaemia, infection, and inflammatory disorders. It is a panel of tests that examines different types of cells in the blood.
The Waitemata DHB Laboratories POCT team oversees and manages the R-POCT service on behalf of both Auckland and Waitemata DHBs. This ensures that all quality assurance and control measures are consistent across all general practices who are members of the Rural Alliance.