Por fin del instituo de Estandarizacion de Laboratorio Clinico se ha dedicado a la estandarizacion de los Puntos de Contacto (PoC) en los desastres de forma exhaustiva, incluyendo por supuesto la ANATOMIA PATOLOGICA (a pesar de la discusión que genera en España) y en su totalidad se tiene en cuenta la TELEMEDICINA tal como nosotros indicamos en el año 1992 con el ITU- Telemedicine Support Center y en el que se tiene que reconocer el estandar Plug & Play (IEEE 11073). Aqui adjuntamos el listado de va a cubrir.
1. Scope
2. Introduction
3. Standard Precautions
4. Terminology
5. Quality Control and Quality Assurance Procedures
5.1 Device Maintenance and Calibration
5.2 Electronic and Automated Quality Control
5.3 Minimum Proficiency Requirements
6. Regulatory Considerations
6.1 Altered Standard of Care
6.2 United States: The Joint Commission (TJC)
6.3 Food and Drug Administration and Clinical Laboratory Improvement
Amendments (CLIA) Waived Devices
6.4 College of American Pathologists (CAP) Accreditation
6.5 Health Insurance Portability and Accountability Act (HIPAA) Certification
6.6 Abroad: Joint Commission International (JCI)
7. Uncontrolled Environments’ Confounding Factors
7.1 Interferents
7.2 Inhibitors
7.3 Environmental Factors
7.4 Contamination
7.5 Reagent Expiration, Storage, and Handling
8. Troubleshooting Point-of-Care Devices in the Field
8.1 Environmental Robustness
8.2 Calibration
8.3 Technical Support
8.4 Replacement Instruments
9. Education (“Just in Time” Training)
9.1 Preanalytical Sample Processing
9.2 Specimen Processing and Handling
9.3 Postanalytical Processing
9.4 Reagent Expiration
9.5 Contamination
9.6 Quality Assurance
9.7 Proficiency Requirements
10. Training (Simulation)
10.1 Good Laboratory Practice
10.2 Disaster-Specific Standard Operating Procedures
10.3 Device Maintenance
10.4 Confounding Factors
10.5 Workflow
10.6 Crossover Training
10.7 Outreach for Proficiency Before Disaster
11. Strategic Testing Sites and Triage
11.1 Altered Standard of Care
11.2 Alternative Care Facilities
11.3 Regional and Community Hospitals and Clinics
11.4 Portable Intensive Care Units (POC-ICU)
11.5 Reagent Storage and Stability
11.6 Supplies Archiving and Cycling: Systematically Updating Resources
12. Disaster Response Personnel Using POCT
12.1 Nurses
12.2 Point-of-Care Coordinator
12.3 Laboratory Director
12.4 Physicians
12.5 Medical Technologists
12.6 Firefighters
12.7 Emergency Medical Technicians (EMTs)
12.8 Disaster Medical Assistance Teams (DMAT)
12.9 Volunteers
13. Transportation of Personnel and Supplies
13.1 Hospital, Community, and Federal Response
13.2 Air -, Land -, and Sea-Based Transport Considerations
13.3 Use of Pre-positioned Equipment
13.4 Supply Prioritization: Acute Care
14. Responder Resources
14.1 Food, Water, Facilities, and Biohazard Disposal
14.2 Power (AC/DC)
14.3 Area of Responsibility and Proximity to Other Teams
14.4 Sustainability
14.5 First-Responder Health Considerations
14.6 Human Resources Support
14.7 Translators
15. Interoperability of Personnel and Equipment
15.1 Battery Interchangeability
15.2 Modular Laboratory Caches
15.3 System Lockout
15.4 Common Spare Parts
16. Connectivity
16.1 Electronic Medical Records
16.2 Wireless Connectivity
16.3 Remote Imaging
16.4 Field Area Networks
16.5 Access to Digital References
16.6 Personal Communications Systems
16.7 Data Management
16.8 Computer Servers
16.9 Network Security
17. Positive Patient Identification
17.1 Established Patient Identification Protocols
17.2 Bar-coding
17.3 Access to Hospital Information Systems
17.4 Patient Tagging for Secondary Follow-up
18. Security
18.1 Wireless
18.2 Logistical
19. Public Health Considerations
19.1 Endemic Pathogens or Health Considerations
19.2 Patient Isolation
19.3 Critical Care Management
20. Transitioning From Response to Recovery
20.1 Post-traumatic Stress Disorder
20.2 Management of Chronic Diseases
20.3 Follow-up Management of Acute Diseases
20.4 Counseling Services
20.5 Point-of-Care Testing Results Documentation
20.6 After Action Reporting
21. Recommendations for Future Disasters
