Who gets treated first?

It is a familiar scene in many emergency departments: several ambulances arrive within minutes, the waiting room is full, and medical staff must quickly decide which patients require immediate treatment. Every decision is based on clinical experience, standardized triage systems, and the information available at the time. However, not all diagnostic data are available at the beginning of a patient's care. Many laboratory parameters only become available later in the diagnostic process.

This is where point-of-care testing (POCT) comes in. Point-of-care tests performed directly at the patient's bedside or near the emergency department provide critical laboratory results within minutes, creating a valuable foundation for time-sensitive clinical decisions. But what are the actual benefits of POCT? Which point-of-care tests are commonly used in emergency medicine? And what are the limitations of decentralized diagnostics?

While many decisions are initially based on symptoms, vital signs, and clinical assessments, laboratory test results can provide crucial insights. POCT does not, in and of itself, change the triage process. The decision about who is treated first remains the responsibility of a physician. However, point-of-care testing provides additional objective information at an early stage, which supports clinical decision-making following the initial assessment and can more quickly confirm or rule out suspected diagnoses.

Point-of-care testing refers to diagnostic testing performed directly at the site of patient care, such as in the emergency department, the resuscitation room, or at the bedside. Unlike a traditional central laboratory, there is no need for transportation and many intermediate organizational steps. The results are often available within just a few minutes.

POCT reduces the time it takes to obtain relevant laboratory results, thereby supporting subsequent diagnosis and treatment. Particularly in time-critical conditions such as heart attack, sepsis, or pulmonary embolism, laboratory results available early on can complement the initial clinical assessment and accelerate further treatment steps.

Modern POCT systems achieve high analytical performance across many clinical applications. Nevertheless, the validity of a test result does not depend solely on the technology. Accurate diagnostics require validated test methods, regular quality assurance, trained personnel, and standardized workflows. It is equally important that test results are documented reliably and integrated into clinical decision-making processes. Only under these conditions can POCT realize its full potential in emergency care.

In addition, not all laboratory parameters are equally suitable for point-of-care testing. While POCT excels in time-critical clinical situations, comprehensive specialty testing and more complex analyses remain the responsibility of the central laboratory.

When treatment decisions in the emergency department must be made within minutes, rapidly available laboratory results can provide valuable support for the initial clinical assessment. Point-of-care testing does not replace either clinical expertise or the central laboratory. Instead, it helps clinicians make faster and better-informed decisions. Given the rising number of patients and the increasing complexity of emergency care, point-of-care diagnostics are likely to become even more important in the future as a complementary tool to clinical expertise and central laboratory services.