ER stroke POC testing
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Does anyone perform POC testing in the ER for stroke patients? What type of testing do you perform, besides INR?
Thanks!
Deborah Martuch, BSMT(ASCP), CPP
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I am surprised that you are performing POC INR testing on stroke patients as most of the intended use statements state that the test is specifically for monitoring patients on Warfarin. I think the one exception may be the Hemochron Signature Elite. Is that what you are using? We do not do any POCT as a part of the Stroke Protocol. Getting the blood drawn for testing has been pushed to the top of things that need to be done once the patient gets to the ER.
We currently don't perform any POC testing for our stroke patients in the ED but wasn't sure what others may be doing. I have read articles about using an INR device in the ED so was curious if anyone was using it.
The subject has come up in our ED meetings.
Thanks!
Deborah Martuch
We've been doing the Hemochron Citrate INR in our ED along with iSTAT Trop and BNP CHEM8 and CG4. We also fast track samples in the Lab: CBC, BMP or CMP, TSH, FT4.
We are doing iSTAT Chem8 to determine presence/absence of hyponatremia, which often accompanies stroke.
Although we strongly advise and train against using iSTAT PT-INR for any patient where the warfarin history is undetermined, I'm sure some are still getting done.