WIP 08 - Exploring the Impact of Point-of-Care Electrolyte Testing in a Pediatric Emergency Department: A Case-Control Study

Publication Number: WIP 08.7706

Benjamin Roshak, William Beaumont University Hospital, Clawson, MI, United States; Margaret Menoch, Beaumont Children's Hospital, Royal Oak, MI, United States

Background: Point-of-care testing (POCT) refers to laboratory tests performed at or near the patient’s bedside, providing rapid results that are particularly valuable in emergency departments (ED). Quick results enable faster decision-making and treatment in busy ED settings. While the utility of POCT in adults has been widely studied, research in the pediatric population remains limited. The impact of POC electrolyte testing in children is not well understood, but it could prove invaluable, especially in low-resource environments. Several studies have demonstrated that POC electrolyte testing provides accuracy comparable to standard lab testing, highlighting its clinical usefulness. However, previous research has yielded inconsistent findings regarding electrolyte POCT effect on ED length of stay. Despite evidence of significant POCT use in ED, there remains considerable room for increased application. Further studies are needed to demonstrate its effectiveness and impact on key metrics.

Objective: This study aimed to evaluate the impact and utility of POC electrolyte testing in a pediatric ED. We hypothesized that its use would reduce both length of stay and the need for lab testing. The primary outcome was ED length of stay, while secondary outcomes included lab testing and IV fluid administration.

Design/Methods: IRB approval was obatined per institutional protocol. This retrospective matched case-control study was conducted in an urban pediatric ED from 2017 to 2020. Groups were matched on age, chief complaint, disposition, and year. Electronic medical records were reviewed to assess the use of POC electrolyte testing, standard lab tests (BMP/CMP), IV fluid administration, and ED length of stay. The use of POCT was at the discretion of the treating provider, and groups were further stratified by chief complaint into respiratory, GI, and other categories. A total of 1,079 patients were included in each group and we compared lab testing, ED length of stay and IV fluid administration between groups. Additional data on patient acuity and frequency of ICU admission was also analyzed.