Point of Care Influenza Testing in the Pediatric Emergency Dept.

Key Points:

• 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.

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Key Terms:

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.

Reference:

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.