iSTAT B-hCG Testing
Is anyone currently running the iSTAT HCG in their ED on whole blood? Currently, phlebotomists and nurses draw and tube specimens to main lab for plasma HCG levels on our Siemens Vista 1000T. Vista reportable range is <1 to >200,000 IU/L. We do not offer POC urine HCG tests. We perform about 450 HCGs between our two ED locations in a month. Our current TAT from order to result is less than one hour for the Vista quantitative plasma HCG level.
1. I would like to know others experience with sensitivity and specificity of the iSTAT HCG compared to their in-lab methodology.
2. How do other labs handle the iSTAT HCG result when it is >2000? Do you confirm by the inlab method?
3. Do you report the qualitative or the quantitative iSTAT HCG?
4. Who performs the iSTAT HCG? Phlebotomists, nurses, and/or MLS?
5. Which CAP proficiency survey do you run?
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1. The cartridges matched up well to our Vista in the lab, we didn't have any issues there.
2. Providers would have to order an in-lab hCG quant if they wanted to "confirm" a >2000 with the Vista.
3. We reported the qualitative and quantitative results. One of the complaints from our ED providers was about the "indeterminate" results the cartridges give for hCG levels of 5-25. In those situations they would order a lab hCG...which gave them the same information (eg: hCG of 11 or a qualitative test with a very faint line).
4. Nurses/ED techs would run the testing, as they collect the initial blood samples from our patients.
5. We used the C1 survey from CAP.
We actually just eliminated i-STAT BhCG testing in our ED due to concerns about the cost-effectiveness of the test. When pulling the cartridge, we emphasized the importance of getting hCGs reported out ASAP with our lab staff and we haven't had any complaints from the ED that I am aware of.