In two of the hospitals that received media attention while caring for hospitalized Ebola patients, Emory University Hospital (Atlanta, Georgia) and the University of Nebraska Medical Center, ONLY point-of-care (POC) testing was used to care for the patients. Other facilities also chose a similar approach by implementing an array of diagnostic testing used to care for potential/confirmed EVD patients. The University of Chicago Medicine (UCM) set up a room near their isolation area for EVD suspect patients. The room provides the instrumentation and supplies required to perform the most comprehensive offering of diagnostic tests as is feasible. Diagnostic testing available at UCM includes thin-smear malaria testing and rapid molecular diagnostic testing, including respiratory, gastrointestinal, and blood culture identification using BioFire's FilmArray® panels.
Each hospital will develop a site-specific plan to determine if POC instrumentation will be utilized and to what extent. The CDC warns of the dangers that exist when changing to unfamiliar/new devices without providing sufficient training. A breach in safe practices can result in exposure. Staff also needs sufficient time to practice using the instruments in advance, while wearing the required PPE. The laboratory must also ensure compliance with applicable Clinical Laboratory Improvement Amendments (CLIA) regulations, based on the complexity of the testing performed.
If the laboratory is using POC testing devices to provide care for patients with EVD, an alternate specimen transport plan should be in place in the event that a POC device fails.