Time-critical neurological emergencies: the unfulfilled role for point-of-care testing

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• 作者：Jason T. McMullan (1)
  William A. Knight (1) (2)
  Joseph F. Clark (3)
  Fred R. Beyette (4)
  Arthur Pancioli (1)
  
• 关键词：Point ; of ; care systems ; Neurology ; Diagnostic techniques ; neurological ; Emergency medicine ; Brain ; Critical care
• 刊名：International Journal of Emergency Medicine
• 出版年：2010
• 出版时间：June 2010
• 年：2010
• 卷：3
• 期：2
• 页码：127-131
• 全文大小：118KB
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• 作者单位：Jason T. McMullan (1)
  William A. Knight (1) (2)
  Joseph F. Clark (3)
  Fred R. Beyette (4)
  Arthur Pancioli (1)
  
  1. Department of Emergency Medicine, University of Cincinnati, 231 Albert Sabin Way, PO Box 670769, Cincinnati, OH, 45267-0769, USA
  2. Department of Neurosurgery, University of Cincinnati, Cincinnati, OH, USA
  3. Department of Neurology, University of Cincinnati, Cincinnati, OH, USA
  4. Department of Electrical Engineering, University of Cincinnati, Cincinnati, OH, USA
  

文摘

Background Neurological emergencies are common and frequently devastating. Every year, millions of Americans suffer an acute stroke, severe traumatic brain injury, subarachnoid hemorrhage, status epilepticus, or spinal cord injury severe enough to require medical intervention. Aims Full evaluation of the diseases in the acute setting often requires advanced diagnostics, and treatment frequently necessitates transfer to specialized centers. Delays in diagnosis and/or treatment may result in worsened outcomes; therefore, optimization of diagnostics is critical. Methods Point-of-care (POC) testing brings advanced diagnostics to the patient’s bedside in an effort to assist medical providers with real-time decisions based on real-time information. POC testing is usually associated with blood tests (blood glucose, troponin, etc.), but can involve imaging, medical devices, or adapting existing technologies for use outside of the hospital. Noticeably missing from the list of current point-of-care technologies are real-time bedside capabilities that address neurological emergencies. Results Unfortunately, the lack of these technologies may result in delayed identification of patients of these devastating conditions and contribute to less aggressive therapies than is seen with other disease processes. Development of time-dependent technologies appropriate for use with the neurologically ill patient are needed to improve therapies and outcomes. Conclusion POC-CENT is designed to support the development of novel ideas focused on improving diagnostic or prognostic capabilities for acute neurological emergencies. Eligible examples include biomarkers of traumatic brain injury, non-invasive measurements of intracranial pressure or cerebral vasospasm, and improved detection of pathological bacteria in suspected meningitis.