Cath Lab ACT

Hello,

If you were to start a new Cath Lab, what ACT platform would you get?

Thanks!

Stacie

Edited Mon, Jul 30, 2018 3:05 PM

Replies to this Topic

Unfortunately at the hospital I work at, it is up to the perfusionist and the surgeon which machine is used.  We have both the Medtronic ACT (perfusionist choice) and Hemochron Signature Elite (surgeon's choice which the nurses use).

Char

 

I would choose iStat, and it must be interfaced, the only downside is it is expensive if the volume is not high, I mean running over 1000 test per month.

I currently use iSTAT ACT as well. Let me know if you need any reference materials and I can forward those to you.

iSTAT ACT-k.  My Cath Lab likes it because there's less work to QC, also used in the OR (more utilization and back up supply if needed) and it's interfaced.  I occasionally round with them or take other reps up to talk to them and they still choose the iSTAT.

 

We use iSTAT ACTk in all OR's, Cath, Imaging Intervention. It's nice to only have one platform to deal with, and is more precise than previous methods we used.



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Hi,

Thank you all for your responses.  The newly hired Cath Lab Director wants a Hemochron Elite.  I asked if he would be interested in the i-STAT and he said no.  I was hoping he would have liked to have spoken with both vendors but he prefers the Hemochron.

Stacie

Our main cath lab doc insists on the Hemochron (this was in place prior to my starting). I think that part of it is what they trained with or used at previous locations. There is also the thought that it is quicker (the cuvette pre-warms prior to applying the sample unlike the ISTAT). The complication here is the limitations due to H/H values. Being a pediatric hospital, there are times that we exceed the upper cut off. TPN can also complicate things. Interesting thought: our cardiac OR actually uses both the ISTAT and the Hemochron. They start the case with both and then end the case with both. I do wish we could be exclusively ISTAT.

I think what always tells the story about an ACT method is when you look at peer data from CAP on the latest ACT survey. The Hemochron's consistently have the widest SD, usually +/- 40-50 seconds where the iSTAT is more like +/- 10. I tell the cath docs, would you rather have a result in 4 minutes with a target of 250, that is somewhere between 210 and 290? Or one that takes 5 minutes and you know it is between 240-260?

Well stasted.  But the docs still like the time factor........


Nancy Epstein

Point of Care Coordinator

CHI Health Laboratories

402-398-6603 (office)


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We converted from the Hemochron to the i-STAT Celite ACT back in 2005.  Our Cath Lab docs were initially reluctant as the time to result was longer with the I-STAT than with the Hemochron.  However, once they realized they could get their creatinines, INRs, BMPs and ABGs on an as needed basis from the I-STAT they were willing to sacrifice the extra minute to result for the ACT.  The I-STAT has had a tremendous impact on improving their workflow.  As mentioned, the precision on the i-STAT is far superior to the Hemochron.

We run our I-STAT ACT Celite cartridge in the "nonwarm" mode and our Kaolin for open hearts in the "prewarm" mode.

Could someone please send me the latest peer data from CAP on ACT. We use WSLH and I would like to look at both. I am also going through the CATH lab wanting a Hemachron instead of an iSTAT.

 

Thank you very much in advance.

Valerie Kornegay

vkornegay@osumc.net

 

Hi Jake -  I would like the reference material for iSTAT ACT please.  I will be initiating the iSTAT in the Cath lab and OR for ACT (replacing Hemochron).  bpost@ghvhs.org  Thank you

To all,

I have replaced Hemochron in two large hospital systems (12 hospitals total)  with the ISTAT. When I was the first in San Antonio to do this, (2004) physician resistance was huge. The docs referred to the ISTAT as the "I-SLOW". The resistance to the changes in the ranges for heparin from the Hemochron was considerable. The "180" number had been codified in docs when they were trained.  I found myself chasing orders that came from the other systems  to my system to change the ACT pull number. Many of the docs came around after I published on ECMO when using the ISTAT because the patient outcomes were better. 

Eventually, the docs got used to it. All of San Antonio, 3 major systems of about 20 hospitals,  use the ISTAT now. This gives all POCC and patients the advantage of having one sheath pull number for the whole city. The docs will still write "180" but the nurses have been trained (at least at the systems that I installed) that the standard is 150. It is also in Cerner on the order set.  

Lastly, with the usage of closure devices in the Cath Lab, as well as better drugs like Angiomax,  seldom does sheath pull happen on the units now. It is strictly after care for sheath pull. With a closure device, seldom is an ACT even performed before the pull is done. Our volume has fallen by more than 4000 a year-even with increased cardiac volume. I have reduced ACT operators on ICU units by over 2/3.

Let me know if you have any questions. Deanna Bogner 210-297-9657

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