AVOXIMETER 4000

Hmm,  AVOX devices are generally used in cardiac cath labs where it's only the cooximetry values that are needed.  It can't do a full blood gas, whereas almost every blood gas analyzer does, these days (unlike the old days, lol).  So, it sounds like an odd fit for a Respiratory Department, where there is a need for a full gas?

Planning to replace RapidPoint with EPOC and Avoximeter

Ahh, I see.  Yes, that's a limitation of EPOC (and iSTAT) for sure.  There are parts about AVOX that are clunky, I would say.  To start, there are no QC lockouts, other than the optical QC (no liquid QC lockouts).  It also cannot accommodate a patient identifier that is greater than 11 characters, which is a problem with most patient registration systems (MediPAC, EPIC, all use 13).  That means using something less than 11, which is often an MRN, but there is no barcode reader on the analyzer, which means staff would have to type in the number, and is therefore more error-prone.  Results can be interfaced with a Lantronix box to Telcor and probably other middleware as well.  Lastly, it keeps the old patient ID in the analyzer for an hour before it automatically clears it (this is generally a convenience in a cath lab setting where the same patient is tested repeatedly).  Your staff would have to remember to put the new patient's ID in the analyzer if it's been <1 hour since their last sample.  I think that alone could be a real headache in a respiratory department setting.

Thanks James... really appreciate it 

I would highly recommend a different route unless this is to be used in a cardiac setting. We have avox 1000 and 4000.
Avox are extremely expensive considering their lack of connectivity. There is a single serial port on the back. If you choose to interface it with a lantronix box you won't have the option of a printer. There is no barcode reader option.
Keep in mind, the tech for Avox was put into a patent application in 1992.

A Gem 5000 will give all the same results without the concern of manually entering everything. 
Our quotes were also several thousand less for a Gem 5000 than the avox.

The Gem 5000 is similar to the rapidpoint but with the benefit of their being less boxes/consumables, room temp storage, and faster turnaround between tests (45 seconds per test).

Whatever route you choose to go, make sure you get your hands on an avox 4000 to see before you make the purchase.

To Nicholas' comment, you can have a printer option if you get a splitter cable that splits the output between the Lantronix and a printer.  But that still doesn't make it a good fit, lol.  Best summary is Nick's comment that the technology is from 1992, with no significant improvements.

James, I didn't know you could use a splitter. Heck, my service rep didn't know you could use a splitter and I specifically asked if that was an option.
I'll have to explore this now, thanks for the info!

To add to James and Nicholas's points:

Con's

Pro: it can perform a Co-ox test in ~10 seconds which the Cathlab loves.  

The Prime Plus will do a Co-ox panel in 45 seconds and be ready for the next sample 15 seconds after that.

 

Nicholas - yes, you can use a splitter cable but it seems they are sooo hard to find through typical hospital vendor channels.  Here was our solution from KMDDI, late last year.  I'd reach out to their sales rep (Thomas Chieze) to see if he can help you out as well.

Jeremy also makes excellent points, all true.  I have never had an issue with the cal ver though, provided I use the RNA Medical product for AVOX.  I can't imagine using the AVOX on a large scale with that many users.  The most egregious issue is that patient ID not clearing from the analyzer after 15" like the manual says it does.  I reported that to them 12 years ago, they verified it's a glitch, but here we are all these years later with still no fix.  Nurses love the <10 sec throughput though...

We also used the RNA Cal/Ver's for the Avox, even after disassembling the photodetector and cleaning it (which did correct the issue sometimes) we and vendor service couldn't get a number of Avox's to pass Cal/Ver.  We ended up purchasing a few new ones and reducing inventory also depending on the location.  The Avox's were a regulatory ticking time bomb just waiting to be discovered, but that's history for us now.

Agree Jeremy.  I think the only reason it still is a good fit for us is volume has really dropped off, minimal number of staff, and therefore not a lot of wear/tear.  Since the only cost is the cuvettes and QC (minimal), it is hard to beat the economy and the fast TAT.  But I couldn't imagine it in a larger setting, logistically.

We are in the same boat as Jeremy MacDonald with some of the RNA Cal/Ver samples running out-of-range high for HbO2 (and sometimes THb).  We've sent several AVOX 1000 instruments back to Werfen over the past year due to this problem.  One of them was sent back twice with no resolution of the problem.  We asked for the devices to be recalibrated and were told that is not possible.  Werfen states that the AVOX's "pass" their internal calibration standards during service but will not share information on how they accomplish that.  We've also contacted RNA Medical about the Cal/Ver solutions and they deny any other complaints.  We're at a point where the weekly controls and patient comparisons are passing.   Our CAP proficiency studies have passed but seem to run on the high side compared to our peers.  Is anyone else seeing this problem with the RNA Cal/Ver samples with older AVOXs?  If you've recently replaced your AVOX 100 analyzers recently, we'd appreciate knowing the pros and cons of your new devices.  Many thanks!