Page 110 - COVID-19 Inpatient Training Resources

April 24, 2020
Version 4.0
Prepared by: Dr. Larissa Matukas (Medical Microbiologist and Head of Microbiology Lab)

COVID-19: Considerations for point of care testing (POCT) in patients under
investigation (PUI) or positive for COVID-19

Introduction

Point of care testing is typically performed to provide results faster than what can be achieved by sending
the specimen to the laboratory for testing in order to determine a patient’s management or treatment
immediately. All testing regardless of the location of testing must adhere to good laboratory practices and
appropriate biosafety and biosecurity precautions. Local risk assessments should be conducted to
identify mitigating processes and procedures to reduce to the risk of testing to acceptable levels. 1,2

Public Health Agency of Canada has classified SARS-CoV-2 the agent responsible for causing COVID-19
1
as risk group 3. However, the risk of acquiring COVID-19 from clinical specimens is unknown. PHAC
and the WHO have issued biosafety advisories to mitigate the risk of transmission to healthcare workers
who perform laboratory testing and have been applied to patient specimen testing at Unity Health
Toronto.

Biosafety Considerations for POCT

Local Risk Assessments:

Local risk assessments should be performed to decide if POCT can be performed safely or the
specimens should be hand delivered to the laboratory for testing. Some factors to be considered are:

 Activities which can potentially exposure persons, equipment and/or environment (aerosols/
droplets) with body fluids.
 Volume/ frequency of testing. As higher volume of tests can lead to higher risk of potential
exposure.
 Disinfection using hospital approved disinfectant
 Safe waste management as per hospital policy

Consideration for testing using POCT device:

 For most POCT, it is safest to process and test specimens from PUIs within the laboratory.
These specimens MUST be labeled as STAT, COVID-19, and hand delivered to the laboratory.

 However, if clinically warranted, only perform POCT at the bedside in the patient room, that
requires minimal intervention and uses dedicated meters on the unit for the duration of their
isolation e.g. finger prick for glucometer. Ensure to use proper personal protection, disinfect the
equipment/ supplies and area, followed by dispose contaminated waste in a biohazard bag and
sharps container.

 If the POCT cannot be performed at bedside, perform the test in a dedicated space with no other
persons present within 2 meters of the testing. Ensure to use proper personal protection,
disinfect the equipment/ supplies and area, followed by dispose contaminated waste in a
biohazard bag and sharps container.

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