Hemoccult Sensa Card Testing in the ER

Yes we perform this test.  The single test is the symptomatic patient, single diagnostic test "Used for detection of occult (hidden) blood when GI bleeding is suspected or is to be ruled out. Useful for diagnosis related to anemia, esophagitis, ulcers, gastritis, inflammatory bowel disease and other conditions that may result in blood loss through the stool."  The providers need to be aware of the limitations (diet) and consider this in their clinical decision.  We have a slide to remind them of the test limitations in our annual competency.
The asymptomatic patient, serial screening test "Used exclusively for colorectal cancer screening for early detection of cancer in asymptomatic or/or high-risk individuals."

Yes, our ED does perform the fecal occult blood test but we switched them to the Hemaprompt card.  The ED was not compliant with waiting the 3-5 minutes after dosing the card before adding the developer.  They would also lose developer bottles.   The providers are performing the test from a rectal digital exam.  The hemaprompt cards are approved for digital exam specimens whereas the hemoccult sensa is not.

We too use the HemaPrompt card and have been very happy with it.  It can be fecal/gastric or fecal only.  If you're not familiar with it, google or I can send you some info.  It still is guaiac methodology, but at least the developer is self-contained.  Docs are supposed to interpret between 1 and 3 mins.

Agree with all of the responses above, and for the same reasons, we also have switched to HemaPrompt FG cards.  I don't think you'll ever be able to restrict this test from any ED, it's too useful to them and key to triaging patients.  Even if you would restrict it, chances are they'll sneak it in.

We use the single Hemoccult Sensa cards in our ED, performed by ED providers. We also have a slide about its use and limitations in the Provider's annual competency. 

For all the reasons you stated and the difficulty with correct performance, we just "officially" pulled the test from acute care areas. This was pushed by the GI doctors in our system.

Cathy - wow, that's pretty impressive.  Was it driven by too many inappropriate referrals to the GI docs?

We pulled the fecal occult blood cards off the floors/ER in 2019 and have been doing IFOB exclusively in the lab ever since, better test with no compliance issues.
All Gastro occult blood cards are also being done exclusively in the lab.