Mike,
I am old and crochety. But I have had considerable
first hand experience at both ends i.e. I was
responsible for POCT in my last and final job and also
when someone very close to me was extremely ill.
Having to wait hours for lab results, that I knew took
only minutes to perform was a very frustating
experience. But also when I had to go to, say, our
SCBU, when they had a problem with their blood gas or
glucose analyser and got them working again, the looks
of relief and gratitude,from staff and relatives were
proof enough (for me)of their worth. Or if you have
ever introduced and trained a newly diagnosed diabetic
on how to measure their own blood glucose within
seconds.The benefits of POCT are, not many for the
laboratory, but for the medics, nurses and patients.
Perhaps, if (not when) you are a patient and you
overhear "we're waiting for lab results", it may cause
you think differently.
David G Brown
--- Mike Addison <[log in to unmask]> wrote:
<HR>
<body>
<div align="left"><font face="Arial"><span
style="font-size:10pt">Phil Whites message concerning
POCT
of paracetamol and
salicylate raises a lot of important issues.
</span></font></div>
<div align="left"><br>
</div>
<div align="left"><font face="Arial"><span
style="font-size:10pt">The benefits of POCT are in my
opinion
considerably exaggerated
though it clearly has a role. A number of
our profession are clearly
making a good living out of it. Nevertheless the
few studies reported
of the clinical effectiveness of POCT do not show
major benefits. Of
course it is nice to do something at the bedside but
is it effective use
of resources? If the lab can not produce a
clinically relevant
turnround time why is this? Is it because the
lab itself is just poorly
managed or is it because it is insufficiently
resourced? Why is it that
doctors and nurses who consider themselves grossly
overburdened
feel that they have the time, knowledge and technical
skills to do lab
tests at the bedside? Why is it sometimes easier
to obtain money
for POCT than for extra lab staff or to increase
salaries so we can
retain the ones we have or fill
vacancies?</span></font></div>
<div align="left"><br>
</div>
<div align="left"><font face="Arial"><span
style="font-size:10pt">With a well managed and
adequately
resourced lab there should be
only minimal need for any hospital to have POCT.
This is not
beyond the bounds of possibility. It requires
strong leadership from
our professional elders to convince Government and
Trusts of the
need to invest in people, particularly our BMS
colleagues, if we are
to get the quality service needed to support patient
care. Managed
networks are a side issue and a means of avoiding
addressing
crucial problems of recruitment and retention of
staff. </span></font></div>
<div align="left"><br>
</div>
<div align="left"><font face="Arial"><span
style="font-size:10pt">Mike
Addison</span></font></div>
<div align="left"><br>
</div>
<div align="left"><font face="Arial"><span
style="font-size:10pt"><b><u>Declaration of
Interests</u></b></span></font></div>
<div align="left"><br>
</div>
<div align="left"><font face="Arial"><span
style="font-size:10pt">POCT in the Manchester
Children's
Hospitals consists of BGAs on
ICU and HbA1c in diabetic clinic. All aspects of
POCT are under
total control of the lab and all results are entered
into the lab
computer (BGA by electronic link). None of this
is my work but is
due to my colleague Lesley Tetlow.</span></font></div>
<div align="left"><br>
</div>
<div align="left"><font face="Arial"><span
style="font-size:10pt">I am getting old and crotchety
and
possibly may be a patient in the
nearer future than I would wish. I would rather have
my lab tests
done in a CPA accredited lab by a trained and
experienced BMS and
not by someone in a rush to do other things.
Perhaps if they were
not doing POCT they might get my drugs right. I
would rather have
my operations done by a surgeon than by a clinical
scientist but in
these days of multi-skilling who
knows.</span></font></div>
<div align="left"><font face="Arial"><span
style="font-size:10pt">.</span></font></div>
<div align="left"><br>
</div>
<div align="left"><br>
</div>
<div align="left"><br>
</div>
<div align="left"><br>
</div>
<div align="left"><br>
</div>
<div align="left"><font face="Arial"><span
style="font-size:10pt">Dr G.M.
Addison</span></font></div>
<div align="left"><font face="Arial"><span
style="font-size:10pt">Consultant Chemical
Pathologist</span></font></div>
<div align="left"><font face="Arial"><span
style="font-size:10pt">Royal Manchester Children's
Hospital</span></font></div>
<div align="left"><font face="Arial"><span
style="font-size:10pt">Pendlebury</span></font></div>
<div align="left"><font face="Arial"><span
style="font-size:10pt">Manchester M27
4HA</span></font></div>
<div align="left"><font face="Arial"><span
style="font-size:10pt">Tel
0161-727-2250</span></font></div>
<div align="left"><font face="Arial"><span
style="font-size:10pt">[log in to unmask]</span></font></div>
<div align="left"></div>
</body>
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