POC /drawing blood on Ambulance

We have our own EMS service that we manage POC for that includes helicopters, fixed wing aircraft and ground transport. We gave them 6 iSTAT's and 6 Nova glucose meters. We do all of their training and competency assessment, but their results do not transmit automatically to Epic, they have their own computer system and they manually enter any pre-hospital results into that. 

We also will obviously receive patients by transport that is not our own - we get pediatric patients from an 8 state region as we are the only pediatric specialty hospital located between Texas and California. In those cases, we will accept EMS specimens for everything except blood bank and blood culture. In Epic the ER is able to indicate that the specimens were collected in the field.

Hi Silka

I have a few more questions

1. Do you have trouble with istats in flight/truck movement, or do they only perform when parked?


2. Do you bill for the POC results, and are they entered into the HIS, I see that you said EMS has its own computer and the results are in it.


3. Any problems accepting blood drawn by EMS? Our group wants lactic acids, which are time sensitive and I cannot see us accepting those samples. That is why they want to run on transport

We do  not own any of these transport groups, they are all county operated, so we really have no control over anything they do. 

Kim

We have air ambulance, helicopter, and traditional ground ambulance that use the epoc Blood Analysis System for gases and basic chemistry. The air ambulance uses the Nova Stat Strip Express for glucose testing.  The ground ambulance uses the Abbott Precision Xceed Pro. The ground is part of our hospital network. The air is a separate entity that uses our POC team as technical consultants, often bringing patients to our hospital system.

For our ground ambulance:

1. All testing performed in the bus are resulted to the patient's EMR. The epocs are sent via wifi and the glucose meters are docked for result transmission. The results are not "repeated" once in the ED.


2. Specimens are not accepted from EMS. New samples are drawn onsite. Samples for gases are run when bus is stopped. Samples for glucose are tested in any state of movement.


3. There is one CAP standard that speaks to competency when drawing a sample BUT it specifically states the intention is not for non testing personnel. I am not aware of any other CAP standard. There might be something for Blood Bank..an unknown territory for me.

For our air ambulance:

1. All testing performed in the ambulance are resulted to the patient's EMR by scanning documents into a patient chart. Epoc printouts are given to the ED that the patient is landing at. Glucose results do not have printouts. The critical nature of these patients does require follow up with more testing but not necessarily due to the first testing having been done by air ambulance.


2. Epoc samples are run both in air and on ground.


3. The air ambulance is COLA accredited. The flight nurses draw the sample and run the sample. They have training in both. The flight crew does not hand more samples to the ED they present patient to.