Measured O2 Sat in Cath Lab

We use an AVOX 1000E also and the software limitations and lack of a barcode reader weren't necessarily a dealbreaker for us, but it is because we are low volume.  It was also the nursing favorite.

  Other higher volume cath labs in our system use a Radiometer OSM80; it is basically an ABL80 with only the coox module active.  It works well, but last I checked, it does not have a disposable cartridge option for low-volume settings (<100/month), hence you end up wasting a lot of "tests" that you otherwise pay for.  Hence our decision to go with AVOX.

The Radiometer OSM80 does have a 60-day expiration on the reagent, so that also helps a bit. Bit advantage is the ability to interface with POCT middleware. You can interface the AVOX, but it ain't easy!

Hi Dianne,

     We use the ABL 80 FLEX OSM in our cath lab. We are low volume and use the 200 test solution pack. We have never wasted anything because of the QC that is run. It runs internal QC every 8 hours and we run the external once a week to keep everyone competent. A pack usually runs out a week before expiration. It is easy to use, the staff like it and the docs love having results in real time.

Lois Snider

lois.snider@stclair.org

We just purchased an Avox 4000 but it is still being checked by our Biomed department so I haven't been able to test it out yet. I hope it will be an improvement from the Oxicom they were using in the Cath Lab prior to this.

The AVOX 1000e is the only device that is specifically designed for the cardiac cath lab. It is definitely the cheapest option on the market, and the fastest.

The AVOX 4000 is exactly the same, but provides measures for carboxy and methemoglobin which are not usually important to the cath lab. It also does not allow them to do the calculations that the 1000e has.

Any bench top blood gas analyzer like a Radiometer will cost a lot more per test, so if that is important to your lab you will want to look into it. A 200 test reagent pack on most benchtops will cost you around $1500 - 3000 per pack. If you run 100 tests per month in cath lab, that is a cost of $150 - 300 per test. Conversely, a pack of 100 AVOX cuvettes costs about $300, so that would be a cost per test of about $3. Big difference!

Also - use caution before interfacing the Avox. I know it is our way as POCC's to want to interface everything and anything that we can - but Cath Lab does not work that way. Charting every reading during a right heart cath in the Lab Tab of the Patient EMR is potentially going to create a lot of confusion. It needs to be heavily named in the chart that this is NOT the patient's peripheral hemoglobin and oxygen saturation. You should NOT be charting those on the same line as you would an ABG or a CBC, as those are readings directly from the chambers of the heart, during and after a cath procedure. The Cath Lab typically has their own software for charting those values - and our ABG and CBC normal and critical values do not apply in this case. At my current facility I intentionally do not have mine interfaced because of these reasons. Results are documented on a log (very thoroughly I might add, Cath Lab people are AWESOME!!), and this can be audited against their own program where they are entering the results during the case.  You should not be billing for these individually either, as they are included in the cost of a cath procedure.

LOL, math is hard - sorry, I meant $15-30 per test.

Silka - yes, what you stated was similar to the statistics we generated when comparing AVOX to Radiometer with regard to cost - as much as I like Radiometer, I could not look past the significant savings using AVOX.

We interfaced ours - it was not difficult - and all samples were clearly marked as cath lab samples with site, via the middleware.  Really the only drawbacks we had were the lack of a barcode reader, not being able to assign QC lockout nor ranges for liquid QC, and lastly, how the previous patient ID does not automatically clear out unless another one is put in.  But again, because we were low-volume, these things were not dealbreakers.  But for a larger setting they could be.

Yes, at my previous organization we interfaced ours using the boxes provided by Alere at that time. I also hated that they had to remember to clear the previous patient - I think we spent more time fixing results due to that issue than it was worth it to have the interface. Would have been less work to just manually enter them :)

I agree with Silka. The interface is not important for a test that is not chargeable. While I have several high volume Cath Labs, they are my most compliant units. Paper is fine for them. The operator ID lack of lockout just means that I have to keep track of things a bit more diligently. The organization prefers my diligence over an interface that costs real money......

Barcode readers for one patient at a time are not needed again in my opinion for us. We use the AVOX/GEM but have not set up the lockouts for operator and patient ID.

All of the info is in the Horizon Cardiology system....orders, reference ranges per heart chamber etc.

The Radiometer is significantly more expensive. We would never look at it for a low volume place like the Cath Lab due to cost per test alone.

I have had AVOX for a long time in San Antonio. The AVOX was invented here and the inventor used to come and train my Cath Labs. Dr. Shepard ran AVOX out of his garage for a long time......

Deanna Bogner

210-297-9657