IO-I-PTH testing in the OR

We perform it here using the Roche Cobas e411. Though it is POCT, we have technologists performing the test.

What makes the Roche Cobas e411 a point of care instrument. Is that just something your facility decided.  I have always thought when Med Techs perform the testing it is a lab analyzer.  My experience, like with ABGs, that if the Tech did the testing, even in another location it was considered the labs responsibility for oversight.

Thank you for the info.  I will research the e411.

Penny Gooch

penny.gooch@va.gov

The e411 is a quick assay for intraoperative. We have two of them since io-PTH is performed in two locations in our building. Most other assays are too long, 20 minutes or more. We have complete oversight of all POCT here including waived and non-waived. I like having the techs perform this test since compliance is so much better.

Is it moderately complex?

We have had this request several times as well.  Our findings are that no vendors have what we consider a true POCT option for I-PTH.  We did review the Future Diagnostics information, and although they tout it as POC, it is POC only in that the testing could be done near patient.  It does not have the ease of use, small size, transportability feel that we consider POC (small counter or handheld very simple to use system).  We don't consider it as a POCT analyzer from our standpoint.  Therefore our lab is still running all I-PTH tests on automated analyzers in the lab.  Samples are tubed directly to the lab.

Yes, it is mod-complex

Yes, lots of attention on getting either POCT or lightning-quick results on this test, as it is closely tied to patient satisfaction, as well as repeat surgical visits.  Detection of residual PTH reflects the effectiveness (or lack of) of the surgery.  Fast availability means the case can either be concluded or continued during the same episode.  Not having a fast result means another surgical visit at a later time for the patient.  Hence the need.

We'll be implementing in-lab testing for PTH in the very near future as well.  Fortunately we are also physically close to OR suites so it's as close to POC as you can get.

We already have PTH on the chemistry analyzer and we are also on the same floor as the OR suite.  The expectation is that this surgery will be on less than ten patients a year.  I understand good customer service and that even for one patient this can make a difference. I think its even hard for a med tech to stay competent in an where you rarely do the testing and I am even, with the low volume, concerned about providing training for the PA, whom they say is willing to do the testing.

Will you be implementing the STAT PTH.  I understand that there is also a Roche Cobas e411 that also performs the test quickly.

Thanks for your help.

Thank you.  Good reason to train MT/MLTs to perform.

Thank you for sharing that information.  I will investigate the e411.

I agree Bryan.  The test method is the traditional Elisa test on a micro plate.  It takes more than 8 minutes, even with a technologist.

We have lab techs that use the Tosoh A1A-360 analyzer outside the OR room.  Basically it's Lab, not POC.  

Does the Tosoh A1A-360 perform a PTH?  thnx