Enhancing crisis standards of care using innovative point-of-care testing


  • Gerald J. Kost, MD, PhD, MS, FACB
  • Ann Sakaguchi, MPH, PhD
  • Corbin Curtis
  • Nam K. Tran, PhD, MS
  • Pratheep Katip, BS, MT
  • Richard F. Louie, PhD




alternate care facility, bedside testing, critical path, emergency medical system, environmental stress, near-patient testing, needs assessment, point of distribution, reverse stress analysis, therapeutic turnaround time, triage, small-world network, shel


Objective: To identify strategies with tactics that enable point-of-care (POC) testing (medical testing at or near the site of care) to effectively improve outcomes in emergencies, disasters, and public health crises, especially where community infrastructure is compromised.
Design: Logic model-critical path-feedback identified needs for improving practices. Reverse stress analysis showed POC should be integrated, responders should be properly trained, and devices should be staged in small-world networks (SWNs). First responder POC resources were summarized, test clusters were strategized, assay environmental vulnerabilities were assessed, and tactics useful for SWNs, alternate care facilities, shelters, point-of-distribution centers, and community hospitals were designed.
Participants and environment: Emergencydisaster needs assessment survey respondents and Center experience.
Outcomes: Important tactics are as follows: a) develop training/education courses and “just-in-time” on-line web resources to ensure the competency of POC coordinators and high-quality testing performance; b) protect equipment from environmental extremes by sealing reagents, by controlling temperature and humidity to which they are exposed, and by establishing nearpatient testing in defined environments that operate within current Food and Drug Administration licensing claims (illustrated with human immunodeficiency virus-1/2 tests); c) position testing in defined sites within SWNs and other environments; d) harden POC devices and reagents to withstand wider ranges of environmental extremes in field applications; e) promote new POC technologies for pathogen detection and other assays, per needs assessment results; and f) select tests according to mission objectives and value propositions.
Conclusions: Careful implementation of POC testing will facilitate evidence-based triage, diagnosis, treatment, and monitoring of victims and patients, while advancing standards of care in emergencies and disasters, as well as public health crises.

Author Biographies

Gerald J. Kost, MD, PhD, MS, FACB

University of California Davis Point-of-Care Technologies Center and the Point-of-Care Testing Center for Teaching and Research (POCT•CTR), Pathology and Laboratory Medicine, School of Medicine, University of California Davis, California; Affiliate Faculty, Chulalongkorn University, Pathumwan, Bangkok, Thailand.

Ann Sakaguchi, MPH, PhD

John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii.

Corbin Curtis

University of California Davis Point-of-Care Technologies Center and the Point-of-Care Testing Center for Teaching and Research (POCT•CTR), Pathology and Laboratory Medicine, School of Medicine, University of California Davis, California.

Nam K. Tran, PhD, MS

University of California Davis Point-of-Care Technologies Center and the Point-of-Care Testing Center for Teaching and Research (POCT•CTR), Pathology and Laboratory Medicine, School of Medicine, University of California Davis, California.

Pratheep Katip, BS, MT

College of Population Studies, Chulalongkorn University, Pathumwan, Bangkok, Thailand.

Richard F. Louie, PhD

University of California Davis Point-of-Care Technologies Center and the Point-of-Care Testing Center for Teaching and Research (POCT•CTR), Pathology and Laboratory Medicine, School of Medicine, University of California Davis, California.


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How to Cite

Kost, MD, PhD, MS, FACB, G. J., A. Sakaguchi, MPH, PhD, C. Curtis, N. K. Tran, PhD, MS, P. Katip, BS, MT, and R. F. Louie, PhD. “Enhancing Crisis Standards of Care Using Innovative Point-of-Care Testing”. American Journal of Disaster Medicine, vol. 6, no. 6, Nov. 2011, pp. 351-68, doi:10.5055/ajdm.2011.0074.

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