Issues with pO2 corrections on EPOC

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Hello, 
I'm having trouble with my API and CAP surveys failing for the EPOC handheld system. On our last API survey, my staff ran the 5 levels of BG samples, then I used the EPOC manual's pO2 correction equation. I submitted the corrected pO2 results and three of them failed out too high from the acceptable range. If I had not done the pO2 correction, they would have passed. 

We do the pO2 correction per the EPOC manual for QC and Cal Ver and this does help push the results in the median of the range. But for survey samples, it seems to be causing them to fail too high. 

Is anyone else experiencing this on the EPOC device? I'm going to reach out to Siemens and API today, just curious if anyone had any advice. 

Thanks!
Jake
Jacob.Fray@dhha.org 

3 Replies

You should be performing your survey samples in proficiency mode.  Reporting this result automatically removes any set-point adjustments you may have made in your system.
The pO2 is the first analyte to fail when the survey sample hasn't been handled correctly or user bad technique. 
  • Ensure the sample is brought to room temp with the analyzer by following survey instructions.
  • Ensure the sample is well mixed just prior to analysis.
    • Ensure the user doesn't warm the vial with their hands while mixing.
  • Ensure user does NOT aerate the sample prior to analysis, lots of people like to suck up the entire survey vial by pulling the syringe all the way back... bubble.. bubble.  Make sure the syringe plunger is pushed to 0, aspirate up 1/2 the vial.
  • Do not give the survey sample to the user and walk away expecting them to do the above....  watch them. 
  • Ensure you have selected the correct analyzer on the survey submission form.

I agree with Jeremy.  The pO2 is very sensitive.  We do not do any calculations to ours, run in the proficiency QA mode. Be there when they perform, I tell
them when you open it run it.  Do not answer a question, the phone, or step away until the sample is in the test well.  Also the staff want to pull up the sample then turn the syringe tip up to get rid of any air bubbles.  I teach them always keep syringe tip downwards, take off the blunt tip, discard one drop prior to engaging syringe in sample well.  We had recent training review to try and resolve error codes 3,49, and 50. Take aways:1. you can overfill the cartridge, the 
excess fluid leaks into the reader thus causing error codes. 2. remove the capillary tube or syringe from the sample well after inoculating, if not fluid will continue to be pulled across the sensors again resulting in error code. 
Thoughts on Feb 2024 customer notification, when did software versions 3.16.0 begin and what to do between now and June fix?

 Feb 2024 customer notification regarding the error on the bi-carb over 75.
  • I called Siemens support about this and the person I spoke to stated that he believed that the only way the bi-carb could get that high is if the sample was from a line infusing b-carb = contaminated.
  • I spoke to my RT leadership who stated that in 25 years as a RT, they had never seen it that high...
Not a problem for us. 

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Jake Fray
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