Method/Platform to replace ISTAT

Sylvia, the only waived testing platform that offers a Basic is the Piccolo that I know of.

I am waiting on the final decision from our national leadership so I am not sure yet what we will be doing about testing but there are a couple things that might not work for us.

20 minutes for a test result (iSTAT was 2-3) and in a clinic setting that is basically the whole visit.

Controls need to be frozen (we would need to purchase freezers for our clinics and that would be an added cost and space.

Price of the instruments

Here is a link including tests and platforms considered waived by CLIA.

https://www.cdc.gov/clia/docs/tests-granted-waived-status-under-clia.pdf

Katie - CLIA has updated the waived test menu yet.

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CLIA has not updated the waived test menu yet

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Laboratory admin wants me to explore alternatives to the iSTAT.  We currently use the CHEM8+  cartridge(GLUC, Bun, Creat, Tco2, NA, K, Cl, ionized Ca and HCT) and also ACT.  We have analyzers in Cath lab and OR/Recovery.  Anyone use another analyzer for a similar test menu?   Probably still keeping the iSTAT for ACT unless we find something that will include both.  I am a new POCC....Help!

There are several alternatives--Epoc being first on the list. It will do gas, metabolites, lactate, all on one card. All non-waived. Then you could use a blood gas analyzer-GEM500, RapidPoint 500, or ABL90 all do the same--gas, metabolites, and lactate. No creatinine, at least not on GEM or RapidPoint. There is a new analyzer from Nova called Prime Plus--not sure how it is since it's brand new, although we are probably getting that in one of our ORs. Also, IL has a device called the CHEMStat that will do all of the above except pO2 and creatinine. None of these will do ACT, but there is an IL instrument called Hemachron that does ACT--we use it at most of our sites. I don't think there is currently any device that will do the coagulation stuff like ACT, and also Troponin, BNP as well as gas and metabolites. There is a Nova meter that does lactate, non-waived. We use it but it appears to be less reliable on the high end where the results really matter. Others are happy with it. It only does lactate.

This has been a total nightmare, and it's not over yet!

Anyone currently using the Lactate Nova Meter have any info on reliability when it comes to comparisons on the high end?  We are still in the midst of trying to figure out which way is the best way to go. 

Thank you Abbott for making every POCC life a (insert poop emoji) show!!!

I am looking for instrumentation which has the basic chemistries of the Chem8+ but not blood gases.   I did talk to my Nova rep and the NOVA Prime has been approved for use in the US.  The website has not been updated.    Anyone using the IL Gem Chemstat?

How is Nova customer service turn around time? Has it gotten any better? Their customer service used to horrible and slow.

We also are looking to replace istat.  I checked into IL Chemstat but doesn't appear to be cleared for capillary specimens and we use mostly in our NICU.  I am also looking at ABL90 flex, Rapidpoint 500, EPOC and Nova primeplus systems.  We need to be able to perform capillary specimens and at minimum ABG but would also like basic chemistry.  We also have a transport team that need something when they are at rural area for infant pickup and the sending hospital is not equipped to perform testing. Any opinions pro or con for the above platforms?

Also anyone aware of how Siemens is holding up with the rapid change to their profile?

Hi Diana,

I prefer the ABL90 over the RapidPoint500. 

  1. No IQCP because the internal QC use the same pathway as external QC and patient samples.

  2. Only 2 consumables - solution pack and sensor cassette - replaced once per month.

  3. Consumables are very easy to replace.

  4. Can analyze capillary samples.

  5. Has other sample types in addition to arterial and venous.

  6. You can hold the results until they are approved to send to LIS.

  7. You can also document critical result notification on the instrument.

The only problem I encountered with the ABL90 was the Sensor Cassettes over the summer.  There was a bad batch of them.  I had to keep replacing them until a good one was found. 

Our facility has 23 iSTATs. No alternative testing for blood gases as of this time. (It's a nightmare) We have decided to continue using G3+ for blood gases since it's more of a patient issue. We are currently in transition to use ABL90 and hoping for a smooth transition since we are in our CAP window inspection, Switching to Beaker for our LIS on top of this ABBOTT mess. 

We are still going to keep some of our iSTATS in other areas such as OR because they use EG7+ cartridge and ACT-k, Radiology also use creatinine as waived and 2 of our departments are using PT/INR.  So I am hoping iSTAT will stick around. :( 

Donna, I'm playing the same game you are. I do want to keep iSTAT around and have to for now as it's our only troponin method in house and one department with INR and radiology using for Crea. We also have transport team using it.

We fortunately have main labs on each campus and I think after 3 weeks the word has finally reached the majority to send almost everything to the lab. We were able to get CG8s in as we already were using them and have been preserving for Codes only, transport and cath lab/OR.

We are seriously considering ABL90s in the highest use departments so we would have both those and iSTATs going forward.