Point-of-care D-dimer testing in emergency departments.
Overcrowding and prolonged patient stays in emergency departments (EDs) affect patients' experiences and outcomes, and increase healthcare costs. One way of addressing these problems is through using point-of-care blood tests, laboratory testing undertaken near patient locations with rapidly available results. D-dimer tests are used to exclude venous thromboembolism (VTE), a common presentation in EDs, in low-risk patients. However, data on the effects of point-of-care D-dimer testing in EDs and other urgent care settings are scarce. This article reports the results of a literature review that examined the benefits to patients of point-of-care D-dimer testing in terms of reduced turnaround times (time to results), and time to diagnosis, discharge or referral. It also considers the benefits to organisations in relation to reduced ED crowding and increased cost effectiveness. The review concludes that undertaking point-of-care D-dimer tests, combined with pre-test probability scores, can be a quick and safe way of ruling out VTE and improving patients' experience.
King's College Hospital NHS Foundation Trust, London.
Udo
U
Marquardt
City University, London.
Daniel
D
Apau
D000933:Antifibrinolytic Agents / Q000097:blood*; D004632:Emergency Medical Services / Q000379:methods*; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans; D000067716:Point-of-Care Testing; D054556:Venous Thromboembolism / Q000097:blood / Q000175:diagnosis* / Q000451:nursing*
D000933:Antifibrinolytic Agents; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D
deep venous thrombosis; emergency department; point-of-care D-dimer; pulmonary embolism; turnaround times; urgent care centre; venous thromboembolism