Development of a Mobile Laboratory for Sudden Onset Disasters

Ian Marr, Joshua R. Francis, Dianne P. Stephens, Kristy Marshall, David J. Read, Rob W. Baird, Nicholas Coatsworth

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Objectives: Clinical diagnostics in sudden onset disasters have historically been limited. We set out to design, implement, and evaluate a mobile diagnostic laboratory accompanying a type 2 emergency medical team (EMT) field hospital.

    Methods: Available diagnostic platforms were reviewed and selected against in field need. Platforms included HemoCue301/WBC DIFF, i-STAT, BIOFIRE FILMARRAY multiplex rt-PCR, Olympus BX53 microscopy, ABO/Rh grouping, and specific rapid diagnostic tests. This equipment was trialed in Katherine, Australia, and Dili, Timor-Leste.

    Results: During the initial deployment, an evaluation of FilmArray tests was successful using blood culture identification, gastrointestinal, and respiratory panels. HemoCue301 (n = 20) hemoglobin values were compared on Sysmex XN 550 (r = 0.94). HemoCue WBC DIFF had some variation, dependent on the cell, when compared with Sysmex XN 550 (r = 0.88-0.16). i-STAT showed nonsignificant differences against Vitros 250. Further evaluation of FilmArray in Dili, Timor-Leste, diagnosed 117 pathogens on 168 FilmArray pouches, including 25 separate organisms on blood culture and 4 separate cerebrospinal fluid pathogens.

    Conclusion: This mobile laboratory represents a major advance in sudden onset disaster. Setup of the service was quick (< 24 hr) and transport to site rapid. Future deployment in fragmented health systems after sudden onset disasters with EMT2 will now allow broader diagnostic capability.

    Original languageEnglish
    Pages (from-to)170-180
    Number of pages11
    JournalDisaster Medicine and Public Health Preparedness
    Volume15
    Issue number2
    Early online date1 Jan 2020
    DOIs
    Publication statusPublished - Apr 2021

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