Point of Care Influenza Testing in the Pediatric Emergency Dept.
Influenza virus types A and B are common respiratory pathogens in the pediatric population. Seasonal influenza is a significant cause of morbidity and mortality contributing to more than 200,000 hospitalizations and up to thousands of deaths annually in the United States (Patel et al., 2020).
In adult cohorts, rapid testing reduces ancillary testing and reduces length of stay (LOS) for patients in the ED.
This bedside point of care (POC) test has a rapid turnaround time of 15 minutes with sensitivity of 100% for both influenza A and B and specificity of 94%. This optimizes efficiency in the ED because it is performed on demand and eliminates transport time to a laboratory for testing (Patel et al., 2020).
Antivirals can be used to shorten the duration of symptoms for acute uncomplicated influenza if started within 48 hours of illness onset in previously healthy patients.
Antiviral therapy is recommended as early as possible for any hospitalized patient with influenza, any patient younger than 2 years, or children with high-risk chronic conditions.
More influenza testing was done when POC testing was available; however, these patients had less additional invasive testing performed (Patel et al., 2020).
In this study patients tested for influenza with rapid POC-testing had a shorter median LOS. Improvements in LOS have significant implications for ED flow, especially in busy ED's that can reach capacity constraints in influenza season.
Reliable POC testing in the ED may have profound implications for efficiency and patient satisfaction with less need for invasive blood draws, urinary catheterizations, unnecessary blood cultures, and radiation exposure.
Point of care (POC)- Point-of-care testing is defined as medical diagnostic testing at or near the point of care—that is, at the time and place of patient care.
Patel, P., Sturm, J., Smith, S., & Laurich, V. (2020). Point of care influenza testing in the pediatric emergency department. Pediatric Emergency Care, 36(11), 515–518.