title: Thermal stress and point-of-care testing performance: suitability of glucose test strips and blood gas cartridges for disaster response.
abstract: OBJECTIVE
  Point-of-care testing (POCT) devices are deployed in the field for emergency on-site testing under a wide range of environmental conditions. Our objective was to evaluate the performance of glucose meter test strips and handheld blood gas analyzer cartridges following thermal stresses that simulate field conditions.
  
  
  METHODS
  We evaluated electrochemical and spectrophotometric glucose meter systems and a handheld blood gas analyzer. Glucose test strips were cold-stressed (-21 degrees C) and heat-stressed (40 degrees C) for up to 4 weeks. Blood gas cartridges were stressed at -21 degrees C, 2 degrees C, and 40 degrees C for up to 72 hours. Test strip and cartridge performance was evaluated using aqueous quality control solutions. Results were compared with those obtained with unstressed POCT strips and cartridges.
  
  
  RESULTS
  Heated glucose test strips and blood gas cartridges yielded elevated results. Frozen test strips and cooled cartridges yielded depressed glucose and blood gas results, respectively. Frozen cartridges failed.
  
  
  CONCLUSIONS
  The performance of glucose test strips and blood gas cartridges was affected adversely by thermal stresses. Heating generated elevated results, and cooling depressed results. Disaster medical assistance teams and emergency medical responders should be aware of these risks. Field POCT devices must be robust to withstand adverse conditions. We recommend that industry produce POCT devices and reagents suitable for disaster medical assistance teams.
authors.affiliation: University of California, Davis-Lawrence Livermore National Laboratory Point-of-Care Technologies Center, CA, USA. rflouie@ucdavis.edu
authors.forename: Richard F
authors.initials: RF
authors.lastname: Louie
authors.forename: Stephanie L
authors.initials: SL
authors.lastname: Sumner
authors.forename: Shaunyé
authors.initials: S
authors.lastname: Belcher
authors.forename: Ron
authors.initials: R
authors.lastname: Mathew
authors.forename: Nam K
authors.initials: NK
authors.lastname: Tran
authors.forename: Gerald J
authors.initials: GJ
authors.lastname: Kost
mesh_terms: D001784:Blood Gas Analysis / Q000295:instrumentation*; D003080:Cold Temperature; D003955:Diagnostic Tests, Routine / Q000295:instrumentation*; D004189:Disaster Planning; D019544:Equipment Failure Analysis / Q000379:methods*; D005947:Glucose / Q000032:analysis*; D006358:Hot Temperature; D019095:Point-of-Care Systems
chemical_list: D005947:Glucose