BUN in CVOR

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So I was recently notified that our CVOR department has need to use BUN's during cases.  We currently have an ABL in place, but are evaluating other options since the BUN is not possible with the ABL platform.  Does any one have any recommendations?

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The epoc card now has BUN and TCO2.

EPOC is adding BUN and TCO2 to their BGEM card....supposedly this year. I don't have a rep that keeps in touch since Siemens bought them so that is older news. I'll try to reach out and see if there is an update.


Lois.snider@stclair.org


 

Thanks, Karen!  When did this happen?


Told you they don't keep in touch.  lol.


Lois

We are in the process of getting approval from our system to order the new cards. We were told that the new card will eventually replace the old card, meaning the old card will not be available for purchase at some point next year. It is more commonly called the "orange card".


BUN and TCO2 are now available in the EPOC.


The Siemens rep had demonstrated the new cartridge.  


WE were told that we may be  switching  from i-STAT to EPOC because of the cost.


But we need Troponin and ionized calcium.


Does anyone have this experience?


 


How long does the test actually take in EPOC?   


It seems there is a long waiting time before the sample can be injected. 


I know our nurses will not like that “waiting time”


HI Pet,


      The current card has ionized calcium on it. No troponin or co-ox.


Each card runs a 3 min calibration which checks each sensor before it allows you to add the sample. Once you add the sample it's only 40-45 seconds to get your results. During the calibration you can scan your patient armband, choose the sample type and add any other info you choose to....FIO2, peep, Allen's test, etc. We chose not to add extras but they are available if RT is using them.


We started with them in CVOR, added in ICU for nurse intensivists to use for rapid responses and about a year ago added to ER. Docs seem to love them and other than initial complaints from operators during training about the 3 mins...they have all adapted. Everything is on one card, room temp storage so you eliminate all the drama with refrigeration and how long they are good for at room temp. Negatives...they are all moderately complex but I understand the company is working on a way to get certain tests waived. Also, the Hgb is calculated so can't be used for transfusion decisions.


Let me know if you have any other questions.


lois.snider@stclair.org


 

There are also a few subtle differences between the epoc and the iStat. You cannot "blow" a cartridge with too much blood. If you overfill the epoc, the blood escapes out a vent hole and the measurements will still take place. There is just a slight mess to clean up. Also, printing is a bit easier since you can be further away and let the Bluetooth communication take place. The Host (handset) comes right off of the Reader (where the card is inserted). This can ease use of entering patient sample data while the card is calibrating.


We use the epoc in our ambulance transport for PICU/NICU, Surgery and our air ambulance.


Let me know if I can help any further.


Erika Deaton-Mohney


deatone@bronsonhg.org


 

We perform TAVR procedures in our CVOR and they have stated that they need that during this procedure. I believe it is due to them using the radiographic dyes during the catheterization process.

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