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Development of a Mobile Laboratory for Sudden Onset Disasters

Published online by Cambridge University Press:  21 April 2020

Ian Marr ,
Joshua R. Francis ,
Dianne P. Stephens ,
Kristy Marshall ,
David J. Read ,
Rob W. Baird  and
Nicholas Coatsworth Open the ORCID record for Nicholas Coatsworth [Opens in a new window]
Ian Marr*
Affiliation:
National Critical Care and Trauma Response Centre, Darwin, Australia
Joshua R. Francis
Affiliation:
Department of Paediatrics, Royal Darwin Hospital, Darwin, Northern Territory, Australia Menzies School of Health Research, Darwin, Northern Territory, Australia
Dianne P. Stephens
Affiliation:
National Critical Care and Trauma Response Centre, Darwin, Australia Menzies School of Health Research, Darwin, Northern Territory, Australia
Kristy Marshall
Affiliation:
Territory Pathology, Northern Territory, Darwin, Australia
David J. Read
Affiliation:
National Critical Care and Trauma Response Centre, Darwin, Australia
Rob W. Baird
Affiliation:
Territory Pathology, Northern Territory, Darwin, Australia
Nicholas Coatsworth
Affiliation:
Infectious Disease Department, Canberra Hospital, ACT, Australia
*
Correspondence and reprint requests to Dr Ian Marr, c/o Menzies School of Health Research, Darwin, Northern Territory, 0810, Australia (e-mail: Ian_Marr@gmx.com).
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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.

Keywords

diagnosticsdisasterinfectionlaboratorymobile
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 15 , Issue 2 , April 2021 , pp. 170 - 180
Copyright
Copyright © 2020 Society for Disaster Medicine and Public Health, Inc.

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