Viscoelasticity instrument

Hi Anita, See my previous reply to a VET testing question two months ago. Basically, we decided to implement the Quantra HemoSonic because:
·       It is a user-friendly testing platform, able to provide viscoelastic testing at the Point of Care to evaluate patient hemostasis during selected surgical procedures. CRNAs, residents, and surgeons have been trained and are currently performing the test in the ORs
·       The users can collect the sample in a 3.2% citrated tube and following simple steps can run the test in Quantra. 
·       Results are available on the instrument screen and also can be printed onsite
·       Patient results and quality controls are interfaced via Telcor. User’s logons are also managed with Telcor
·       Results can also be viewed remotely using the Quantra Desktop Remover Viewer (QDRV) application.
 As you can see on the screenshots below, the Quantra is able to provide both numeric and graphic interpretation of the patient hemostasis status. 
Depending of the type of cartridge or procedure, they provide different results: 

 
Test results are also viewable as a coagulation curve showing the development of a clot over time via the Curves View.


I hope this helps. Let me know if you have any other questions.

Yes, we have had them since May 2021......maintaining 5 instruments in the cardiac ORs. Very easy operation, connectivity, and has significantly reduced the amount of blood component usage. The QC material is a bit tedious; set out 30 min, reconstitute and set another 30 min., then transfer soln. back in to syringe-like containers and use....good for up to 4 hours. Load maintenance cartridge once per week; takes 3 minutes & done! Had a couple of them freeze up and require power off and then back on. A couple of the original ones needed a service rep to replace a part to prevent freeze ups.

Another question, what are you using for proficiency testing?  I get a survey from CAP, but it only shows Teg and Rotem as instrument choices.  

There is a CAP survey: Viscoelastic Testing - Whole Blood Survey 

Has anyone tried TEG or ROTEM? 

RajDan,   we had Rotem, currently are using the TEG 6s.. and am now looking at the Quantra

We've had Rotem delta for 9 years, no complaints.  Daily QC check on day of use, weekly liquid QC, semi-annual automatic pipette calibrations, annual PM.  Werfen is no longer supporting our particular serial number, so we are considering a newer Rotem delta, the new Rotem sigma, the Quantra, and possibly Teg.   

Looking for IQCP suggestions for Quantra. Frequency of QC (2 levels daily? 2 levels every 8 hours?). Was the data gathered prior to go live or after?
Any feedback is appreciated. 

Hi Randi, we did go with the Quantra, went live mid-March.  So far so good.  Our Quantra reps stated that most accounts were performing monthly QC.  In developing our IQCP, we ran QCs every day for 30 days.  With those results and our risk assessment, we submitted a plan for monthly external QC and it was approved by our medical director.  I must add that Quantra provides probably the best validation and IQCP materials I've experienced.

Thank you, Anita! Did you perform the 30 days of QC prior to go-live w/patient testing?

Yes, prior to, but you can go live while collecting IQCP data because you're running QC daily and meeting the CAP requirement.  I also included the 5-day validation data as part of my IQCP.

Appreciate your answers! We are Joint Commission but I read that CLIA requires QC every 8 hours for Automated Coag & Hematology instruments. Thoughts? We would definitely love to perform QC 1x/day for cost savings but want to make sure we are ok to do so. Thank you!  

Since HemoSonics does not specify the frequency of QC, it is my understanding that you now have the option to develop your own IQCP, or follow CLIA's every 8-hour QC requirement.  Check out scenarios 2 and 3:                                                                    https://www.cms.gov/regulations-and-guidance/legislation/clia/downloads/cliabrochure12.pdf 

Great. We definitely agree about the option after IQCP is developed to changing to monthly. 
Final question-I promise! How often did you perform QC during the 30 day period when gathering data for the IQCP? Did you do that 1x/day during data gathering process or proceed with the every 8 hours prior to go live? 
Again-thank you so much! It is very beneficial to share info. Thanks for the link. 

Randi, I agree with Anita, Quantra does not specify the QC frequency, however, they recommend running QC with any new lot/new shipment of cartridges and new lot/new shipment of external quality controls, so that's what we are doing. We do not do the 30 days QC on existing cartridges. Regarding the validation studies, we did a 10-day QC on both controls on different days, and a 10 run of level 2 only on the same day.