The Value of Rapid Tests

On a day-to-day basis, laboratory professionals work with an unprecedented number of samples. Both to improve efficiency and protect patient anonymity, these samples are carefully labeled, numbered and processed – ensuring that each sample is examined in a scientific manner. But what happens when things become personal for the laboratorians? The incredible story of a medical technologist at Valley View Hospital1 in Glenwood Springs, Co., sheds light on a very personal situation and the testing that made all the difference.

Before John Spurlock, MT(AMT), finished his shift one night in May to find that his then three-month-old son had become very sick, the laboratory at Valley View Hospital had started validating GI Panels and doing patient comparisons for the BioFire FilmArray PCR. While Respiratory and blood culture PCR testing from BioFire had already received FDA-approval in their laboratory, the GI Panel was in the validation phase at Valley View. As it so happened, the FDA approved testing while Spurlock’s son was still in the NICU for treatment.

“We just happened to have the kit to start our validation,” said Jeanette Refior, MT(ASCP), laboratory director at Valley View Hospital in a recent interview with ADVANCE. “BioFire was able to send us the kits to start doing patient comparisons, so that we can have some data when we are finally able to release it to our physicians to order.”

As his son’s fever persisted throughout the night, Spurlock and his wife grew more and more concerned, eventually calling their physician, who recommended they bring the child in. His temperature remained high and the laboratory and physicians were still unsure of what the problem was even after several tests. The hospital staff was considering doing a Cerebrospinal fluid (CSF) analysis to rule out meningitis, potentially even having the child medevac’d to the Children’s Hospital. The doctor from the ER ordered a Rotavirus, and came up negative.

Spurlock called his supervisor, Nicole Fisher, who recommended running the GI panel – after all, it couldn’t hurt. Despite not expecting much in terms of a result, the test eventually came out with a positive reading for Salmonella, which pointed them in right direction. The GI panel analysis was confirmed the next day with microbiology media, and the physicians could begin treating Spurlock’s son immediately – essentially saving the young child’s life and providing his parents with some much-needed relief.

“We weren’t really thinking of what was going on, and low and behold, right after an hour and 15 minutes or so, the salmonella came off positive.” said John Spurlock, MT(AMT), in the ADVANCE interview. “I knew then that this testing methodology was revolutionary for a stat lab – able to pick up Salmonella in 75 minutes – and also to think that this new testing saved my son, Jacoby’s life. I was truly blessed.

Following such a potentially dangerous situation, neither Spurlock nor Refior could say enough about the value of such a quick PCR test. This rapid technique allows laboratorians to produce results in a drastically shortened length of time in comparison with traditional PCR techniques. The ability to run multiple analyses in a panel simultaneously while still providing results in just over an hour is exactly the kind of test emergency situations require. Refior went on to note another occasion in which a specimen from a physician’s clinic of an adopted eight-year-old from Haiti came out positive on four different organisms. As effective as a stool culture is, it could have never caught all four – the remainder of which could still have infected the rest of the family. Because the test moves so quickly, physicians on staff can begin treatment more quickly, and subsequently, the lab can move on to other pressing situations.

“The old school PCR testing – you had to have a totally sterile room, and the techs had to gown up. There was hours and hours of pipetting and extracting, and you could do one test at a time – one organism at a time,” said Refior. “And, here, we’ve got it set up in our main clinical lab, and there’s not all this hands-on testing.”

For laboratorians, Spurlock’s story should serve as a reminder of the reality behind the tests – that people are directly affected by the results and often need them as quickly as possible. Since the rise of PCR technology in laboratory testing, the precision of instruments has continued to improve, but the speed of rapid testing is what sets it apart. In any case, it was a close – and ultimately lucky – call.

Michael Jones is on staff at ADVANCE.



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