PT/INR meters/analyzers for ER/possible stroke patients
All of the PT/INR meters/analyzer that I know off have been validated for monitoring oral anticoagulation therapy. Using these meters on ER patients, specifically, possible stroke patients would be considered off label testing.
Are any of you using or know of a meter/analyzer that has been validated for testing PT/INR on this group of patients? Patients who are not necessarily on any anticoagulation therapy?
Thank you in advance for any information you can provide in regards to this topic.
Slavica
Slavica S. Stoyanovich, MT(ASCP)
Point-of-Care Coordinator
Saint Joseph Physician Network, POL Consultant
Saint Joseph Health System I Trinity Health
1915 Lake Avenue I Plymouth, Indiana 46563
Ph: 574-948-4286 I Cell: 574-780-3039 I Fax: 574-948-5458
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Me too James! I can’t get the ED Lab to commit to basic lab regulations, so it is a big concern for me. The connectivity issue is going to be a huge issue
for us. We have the machine, but qc and cuvettes are still on order. They are wanting to run PT/PTT for all our ED patients which would be literally impossible. I will let you know how it correlates and our implementation process when we get it into place.
Thanks,
Penny Rose
Good luck!
All-
Just checking in to see how the Signature Elite is working for stroke protocol. Now our ED wants POC PT's on Code Strokes that they say are on Coumadin. They do not have an answer when I ask how they could prove that they were only using the test on Coumadin patients? The pharmacist would like to use the Coag-Sense and have a "check off" in the chart that the patient is on Coumadin so it would not be off label. They would treat with TpA if value is below 1.7 and request a lab PT if POC test was above 1.7. The Coag-Sense is waived, and states that it has some sort of connectivity. We are RALS users and I do not believe it is on their list. Anyone using this device?
So what is everyone doing about Code Stroke PT's in the ED????
So we put the istat pt in use in the Ed not realizing it could only be used on Coumadin patients. We are now back tracking and it is a losing battle. I pull a monthly report and email the head of the Ed who is then suppose to educate the Drs on appropriate use. We have mixed results.
Sent via Groupsite Mobile.
WE had a new group of docs who decided they want the PTINR on the i-STAT because it is faster.
They have them there because we test patients who come in for Stroke protocol if they have history of Coumadin medication.
I have to put a stop to that and explain that the test is intended for monitoring Coumadin only.
They want Coag Screen which is not what the i-STAT PT/INR is intended for use.
We had the Signature Elite in our ED for Stroke patients. ED staff would not keep up with the QC. So it was not ready for use when they needed it. Therefore, it was rarely used. Staff could not maintain competency and finally we took it out. We have a great TAT with the lab for our Stroke protocol so they don't miss.
We had a Hemochron Sig Elite in our ED for several years and it correlated well with the Coag Lab analyzer. They were required to send a PT/INR sample to the Lab to confirm the POC result before they started TPA. They were also required to save the POC tube so we could examine it for volume and labelling. In the last year we started noticing discrepancies between the POC and Lab results. Patients who were taking DOACs would read much higher for the POC INR. We also had a few incidences where the POC test was done on less than full tubes. We stress the correct blood volume in all of our training and competencies - they just don't hear it. We removed the Sig Elite and the ED Leadership team decide that we should meet with each Operator for remedial competency evaluation. That was in mid October and we have not had one single Operator contact us to do the competency. I guess they didn't really need to have the POC test after all.