POC βhCG Immunoassay: Transforming patient care in an Emergency Gynaecology Unit (EGU)

Having ready access to quantitative point-of-care (POC) βhCG testing in its busy EGU has transformed patient care at the Royal London Hospital, Barts Health NHS Trust

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The need for faster POC ßhCG in acute care

The Royal London is one of the city’s leading trauma and emergency care centres. As such, being able to rapidly assess and manage women who may be in the early stages of pregnancy is essential.

While most pregnancy tests measure Beta human chorionic gonadotrophin (βhCG) levels, pregnancy blood tests can detect βhCG about 11 days after conception, several days earlier than standard urine tests [1-3]. In acute contexts where time is of the essence, βhCG blood testing is frequently used at the point-of-care (POC) to reduce turnaround times [4].

Prior to the installation of Radiometer’s AQT90 FLEX at the Royal London EGU, blood tests had to be sent to the laboratory for analysis and results commonly took two to three hours to be reported. The ability to test at POC transformed both patient care and staff workflow.

From left to right: Ms Angela Blanshard – Clinical Nurse Specialist / Ms Vivian Akoto-Mensah – Clinical Nurse Specialist / Mrs Sunita Adhikari – Gynae Matron / Mrs Parvesh Mohan – Clinical Nurse Specialist / Dr Mary Gbegbaje – SAS Doctor

We are able to scan and obtain a blood result within 30 minutes and make a plan of care for that woman and give her the opportunity to make decisions, if necessary, there and then - this can really help to reduce levels of anxiety.

- Mary Gbegbaje, Specialty and Associate Specialist (SAS), Doctor EGU, The Royal London

The advantages of POC testing

The Royal London EGU has now been successfully using the Radiometer AQT90 FLEX for quantitative POC βhCG testing for over 10 years. Professionals and patients have both experienced the benefits.

Mary explains that POC testing has helped prevent unnecessary admissions, free up staff time and resources and has delivered efficiencies and financial savings for the Trust.

Having a POC βhCG is extremely helpful as it allows us to make vital management decisions at the time the patient is in the department, expediting necessary treatment and also reassuring her that she is in good hands.

- Mary Gbegbaje, Specialty and Associate Specialist (SAS), Doctor EGU, The Royal London

Reliable and easy to use

Staff at the Royal London’s EGU have also confirmed that the AQT90 FLEX is ideal for use within their POC setting. The closed tube system makes βhCG testing easy and safe for non-laboratory operators, such as the clinical nurse specialists, to use.

Mary concludes, “I think that for emergencies it is so important to have βhCG results promptly. It really improves a woman’s care pathway and so I would wholly endorse the value of this vital assay at the point-of-care in EGUs and Early Pregnancy Assessment Units. It has certainly proved transformational at the Royal London Hospital EGU over the past 10 years.”

The Royal London

Offers a full range of local and specialist services
One of the largest children’s hospitals in the UK with one of London’s busiest paediatric accident and emergency departments
Home to London’s Air Ambulance
5,000 babies are born each year at the Royal London
181,380 A&E patients cared for in 2019-20
The Royal London Hospital is rated ‘good’ overall by the CQC, with a number of areas rated outstanding including in critical care, dental and maternity

References

1. Poikkeus P, Hiilesmaa V, Tiitinen A. Serum HCG 12 days after embryo transfer in predicting pregnancy outcome. Human reproduction 2002; 17, 7.
2. American pregnancy association https://americanpregnancy.org/getting-pregnant/hcg-levels/
3. Cole L A., Khanlian S. The need for a quantitative urine hCG assay. Clinical Biochemistry 42 (2009) 676–683
4. Fromm C, Likourezos A, Haines L, et al. Substituting whole blood for urine in a bedside pregnancy test. J Emerg Med. 2012;43(3): 478–82.

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