Point of care technology or standard laboratory service in an emergency department: is there a difference in time to action? A randomised trial

We performed a randomised clinical trial with parallel design and allocation ratio 1:1. The eligibility Criteria were: All patients referred from General Practitioner or another referring doctor suspected for a deep venous thrombosis (DVT), acute coronary syndrome (ACS), acute appendicitis (AA) or acute infection (ABI). The outcome measure was the time spend from the blood sample was taken to a clinical decision was made.The study period took place in October--November 2009 and from February to April 2010. 239 patients were eligible for the study. There was no difference between the groups suspected for DVT, ACS and AA, but a significant reduction in time for the ABI group (p:0.009), where the median time to decision was reduced from 7 hours and 33 minutes to 4 hours and 38 minutes when POCT was used. Only in the confirmation of ABI the time to action was significantly shorter.Fast laboratory answers by POCT in an ED reduce the time to clinical decision significantly for bacterial infections. We suggest further studies which include a sufficient number of patients on deep venous thrombosis, acute appendicitis and acute coronary syndrome.The Emergency Departments (ED) are characterized by a high flow of patients with a broad range of different conditions and timely delivery of services is crucial to avoid congestion. In order to achieve a reduction in length of stay every step from admission to discharge must be optimized, including a reduction in waiting time for laboratory results.New technologies for laboratory analysis have been developed, including Point of Care Technologies (POCT) [1]. These technologies ought to be faster and easier to use than the standard central laboratory, and still have a comparable quality of the results [2]. Such technologies are increasingly available and can reduce the transport time and time of analysis significantly compared with central laboratory services [3-5].In an ED a plan of treatment for the patient often depends on a labora