Cath Lab ACT
2 followers
0 Likes
Hello,
If you were to start a new Cath Lab, what ACT platform would you get?
Thanks!
Stacie
13 Replies
Reply
Subgroup Membership is required to post Replies
Join POCT Listserv now
Suggested Posts
| Topic | Replies | Likes | Views | Participants | Last Reply |
|---|---|---|---|---|---|
| iSTAT in NICU -chem 8, CG4 | 3 | 0 | 114 | ||
| Rotem Sigma Validation Help | 1 | 0 | 81 | ||
| Hemochron Sig Elite use outside of manufacturer temperature range | 1 | 0 | 125 |
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.
Notice: The information and attachment(s) contained in this communication are intended for the addressee only, and may be confidential and/or legally privileged. If you have received this communication in error, please contact the sender immediately, and delete
this communication from any computer or network system. Any interception, review, printing, copying, re-transmission, dissemination, or other use of, or taking of any action upon this information by persons or entities other than the intended recipient is
strictly prohibited by law and may subject them to criminal or civil liability. Carilion Clinic shall not be liable for the improper and/or incomplete transmission of the information contained in this communication or for any delay in its receipt.
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)
From: Silka Clark via POCT Listserv (Groupsite) <users+1207902@poct.groupsite.com>
Sent: Thursday, August 9, 2018 9:33:53 AM
To: Epstein,Nancy K
Subject: [POCT Listserv] Re: Cath Lab ACT
CAUTION: This email is not from a CHI source. Only click links or open attachments you know are safe.
The information contained in this communication, including attachments, is confidential and private and intended only for the use of the addressees. Unauthorized use, disclosure, distribution or copying is strictly prohibited and may be unlawful. If you received
this communication in error, please inform us of the erroneous delivery by return e-mail message from your computer. Additionally, although all attachments have been scanned at the source for viruses, the recipient should check any attachments for the presence
of viruses before opening. CHI Health accepts no liability for any damage caused by any virus transmitted by this e-mail. Thank you for your cooperation.
This email and attachments contain information that may be confidential or privileged. If you are not the intended recipient, notify the sender at once and delete this message completely from your information system. Further use, disclosure, or copying of information contained in this email is not authorized, and any such action should not be construed as a waiver of privilege or other confidentiality protections.
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