epoc vs. iSTAT for Flights

ISTAT has been in the Space Shuttle. That is enough of a "flight certification" for me.

ISTAT has a bigger menu in case you have mobile ECMO.

Deanna Bogner

LOL Deanna! 

SA is a big military town.

I spoke with the people who set up the mobile ECMO for the military. They go anywhere in the world for a service members' child if ECMO is needed.

The Hemochron was not flight certified at the time and they wanted to keep the equipment to a minimum.   (this was 2004 or so when the ACT was new on the ISTAT)

They use ISTAT as do a few other mobile ECMO places that I know of-usually children's hospitals like yours. 

The Flight Group that my POC team worked with has chosen the epoc. It was organizationally used for us and made the most sense for our team to assist them in their quest for flight testing. The cards are room temperature, one card for all testing.

It has passed everything to date and the users seem to like it over the iSTAT.

Thanks Erika and Deanna! I did ask our flight team about ECMO and they said it wasn't something they do now, but may in the future. 

Erika - I have heard from at least one site that they get a lot of calibration errors with the epoc test cards before they even have the chance to apply the blood. Are you able to track cartridge waste at your institution? If so, do you know about how much waste you have? I am curious if the issues may have been related to the high altitude here in Colorado.

Do you have an IQCP for the iSTAT in flights?  If so, I would be impressed...and I'd like to see that if you would share. 

If iSTAT testing in flight request get approves for us, we plan to require QC each day of use (prior to patient testing). 

Thanks for any info or assistance you can share!

    Sonya Evans, MT(ASCP)

    POC Coordinator

    Greenville Health System

    Greenville, SC

    sevans@ghs.org

I would like the IQCP as well since we will be going live with our transport team in the next few months.

Are there any concerns that you have thought of or worked out before hand and are you having them do external QC daily or following the internal QC settings for use? All of my istats are set to do QC every 24 hours no matter what location they are in.

Currently our flight team is contracted with the previous healthcare organization that I used to work for, so we are not providing any oversight of their use of iSTATs (however, I was before). The flight for life team at my previous organization has been using iSTATs on their choppers and fixed wing aircraft since before 2006 when I first started doing POC. We used to have to go out to the airplane hangar to run their QC and do their CLEW updates :)  We did not do anything different for their iSTATs beyond what we were doing for the hospital ones - internal EQC set for every 8 hours, and they were included in the six month validations from time to time. I didn't treat their handhelds any different - I can't really see a reason why I would have to? They regulate their own temp and run internal QC on themselves.

Cartridges were a little different story, but they received all of their cartridges from the lab. just like every other department in the hospital. Cartridges were labeled with the room temp expiration dates by the flight team. They can only bring a few on each transport due to the weight restrictions on the choppers. External liquid QC was done in the lab on every lot and shipment of cartridges, and on open stock every 30 days when I was there, but that 30 day QC is no longer required by CAP so at my current facility I have removed it in the IQCP.  Their error rates were no worse than the other hospital departments, so there was no need for us to require them to do extra QC.

We have our transport team run the electronic simulator every 8 hours of patient use as well as programming the auto eqc every 8 hours.  It's not as onerous or expensive as running liquid qc and we can see that it passes in RALS.