Co-Oximetry in Cath Lab
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I was wondering what instrumentation is being used for O2 Saturation in Cath Lab.
I would like to change instrumentation and I would love input on the other instruments out there.
Any information or thoughts you would be willing to share would be greatly appreciated.
Thank You,
Kelly
Kelly VanWagner MLS(ASCP)CM SHCM
Point of Care Administrator
Covenant HealthCare Laboratory
Saginaw, MI
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So you want one that is interfaced? We use AVOX/GEM in all Cath Labs and in the main lab for CO. None are interfaced. We also have not turned on any lockouts on them.
We use the Accriva AVOX 1000E and interface it to Telcor. Works very well. We do turn on the lockouts for User ID, Patient ID and electronic QC (you cannot lock-out for liquid QC frequency).
The advantages are it very much 'speaks' to the workflow of a Cath Lab and the nurse's really like it (as much as nurses can like POC equipment :)
The disadvantages are:
- no barcode reader
- cannot accept any more than an 11-digit patient ID
- cannot lockout for liquid QC performance nor acceptable QC ranges
- cannot "turn-off" parameters you don't use, like O2 content.
Because our number of users is relatively small and the workload is not excessive, these things are not dealbreakers. But they could be in a larger, higher volume setting.
One last caution - it does not report O2 saturation, but more correctly, O2Hb (oxyhemoglobin). Many physicians and nurses refer to the parameter as "O2 sat" but it is really not the same thing. O2 sat reflects dyshemoglobins, O2Hb does not.
I really do not have a preference, as far as being interfaced goes. Though the possibility to do that in the future would be great.
Thank You,
Kelly
Interfacing a COOX device is a lot of money for nothing in my opinion. The results are contained within the Right Heart procedureal charge and are most often entered into the Cath Lab software since they use it for calculations within the procedure.
That is true Deanna, but I think there are still advantages to interfacing any device from a regulatory perspective. Some accreditors want evidence of double-check/reviews of any manually-entered result as opposed to interfaced data where there is generally no (or significantly reduced) opportunity for errors in data entry.
To each his own.....
Deanna Bogner, MT (ASCP)
Regional POCT Coordinator
Baptist Health System
730 N. Main Suite 808
San Antonio, Texas 78205
Phone: 210-297-9657
Fax: 210-297-0845
dxbogner@baptisthealthsystem.com
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We went with the ABL80, as apposed to the Avox. We were able to add an interface easily because we already had radiometers. The ABL80 is easy to use, the downside is the reagent packs are good for 60 days, so there is a lot of waste.
We also use the ABL 80 in our Cath Lab. We order the 200 test solution pack and haven't wasted any. They usually run out at 7 weeks. Of course we run the external QC weekly instead of monthly. We went live 6/17/16 and have run 142 patient tests to date so we aren't a large user.
Lois Snider
lois.snider@stclair.org
Did you need to write an IQCP for the ABL80's? Does your QC frequency mean that you do not have to? Or is the instrument exempt? Any information you might have would be greatly appreciated.
Hi Kelly,
Yes....you need an IQCP for the 80. The manufacturer states it in their info. We ran 3 levels of external LQC daily for 4 months. (mainly because I didn't have time to do the IQCP.) It was always spot on unless they put a bubble in it or other operator generated issue. I left it at weekly so everyone would have a chance to run it for competency. We have had some personnel changes so it keeps them current also. The nurses/techs don't mind running them and they do the ACT LQC weekly also so it keeps them standardized. I may rethink it some day due to cost but for now..... :)
Lois
I think it is ABL 90 that does not require IQCP because it physically run Liquid QC daily.
ABL 80 still need IQCP
Good morning POC world! I am looking for advice on how to handle/review Avox results entered manually into the Cath Lab software. We recently had a state validation and he mentioned that we need to be verifying every Cath Lab manually entered. We do not have them order it in Epic as it is documented on paper and in their systems during the procedure. We don't want to put out the money to interface since we want to switch to the Nova Prime + soon. Any ideas, thoughts would be most appreciated!
Thanks,
Jessica Lang
POC Supervisor
St. Elizabeth Healthcare
Edgewood, KY
We have our Cath Lab scan us their result sheet. Some results we manually enter into the EMR without charges posting since that expense is incorporated within the overall Cath Lab charge. We can review/sign off on the result sheet.
We too will be moving to the Prime Plus in the near future.
Our Cath Lab uses a system called Xper (by Phillips). They document the Avox results in this system.
I can pull up their system to view/print and compare to the Avox results documented in RALS.
I perform this audit periodically, trying to complete at least quarterly.
Deborah Martuch
POCT Manager
Health First
Melbourne, FL
We are considering having them scan result sheets as well. Thanks for the info!