Piccolo Express- CMP Waived

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     Does anyone use the Piccolo Express for CMPs? I also question how it is a waived test panel.  Our Infusion Center department is looking for something that can have a quick turnaround time, especially for BUN, Creat and Calcium.  Any feedback about this analyzer and how you use it in your facility would be greatly appreciated. Thank you!

Annette Tarbuk

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Abaxis submitted their CMP disk to the FDA MANY years ago to be evaluated for waived status when performed on Lithium heparin whole blood. (Abaxis has many other Waived status disks on the market.) We've been using the CMP for at least 15 years in the ED and Micro-hospital setting. To the best of my knowledge, this is the only waived CMP on the market. These have been real workhorses for us, running Comprehensive Metabolic Panel, Basic Metabolic Panel, MetLyte 8 Panel (includes total CK), Liver Panel Plus (includes Amylase and GGT), and Hepatic Function Panel (our only non-Waived panel) disks.

There is a hardware/disk integrity check (iQC - Intelligent QC) that is performed upon startup and with every test. There is a requirement to capture the iQC (hard copy or electronic) for the first patient test of the day of testing to demonstrate that the meter (it is classified as a meter) is working properly. (We happen to capture the iQC for every patient and QC test within our LIS, eliminating the failure point of failing to capture just the first patient test of the day.) This requirement was imposed by the FDA to obtain and maintain Waived status. (The dirty little secret is that if the iQC fails, there will be no patient results reported.) Assay time is approximately 12 minutes.

Points of failure:
  1. Elevated Hemolysis, Lipemia, Icterus (HIL indicators are present)
  2. Over-filling the disk (100 microliters sample size) leading to contamination of the reaction chamber. Allow the sample chamber to self-fill by capillary action.
  3. Fingerprints and/or smudges on the reading surface window
  4. The pipettor is one of the "semi-disposable" pipettors and can become contaminated when (not if, when) the staff releases the plunger too rapidly, sucking up sample into the barrel of the pipettor. They cannot be successfully cleaned.
  5. Over-heating
    1. According to Abaxis Tech Support, the device needs approximately 1.0 cubic foot of free air space around the meter
    2. Do not place the meter under a cabinet overhang as it can trap heat

I think you will like them for your setting.

Thank you for your input! This will definitely help with our decision making.

Annette Tarbuk

HI,
we are using these in our doctor's offices and medical assistants are doing the testing. Will testing be done by MLT or MT (CLS)?

Hello Andrea,

     If we purchase the device, the nursing staff in our infusion center will be performing the testing. According to our policy, nurses are able to perform waived testing. However, training and competency will be maintained by POC. 

HI,
One thing to be aware of is that the QC does not tell you if it passes or fails and will allow patients to run on failed QC. This is one of our biggest challenges. Also, all ranges of QC have to be programmed by each analyte for each new lot of QC. QC is run every new lot, new shipment and once a month. It is difficult to manage if you are not close to the facility running the piccolo. Let me know if you have any more questions.

A couple of other comments regarding- we have issues with the QC often. It doesn't pass at times and we have concluded it is due to the way it gets shipped and stored-(frozen) just FYI. And the analyzer is loud when it is on. Just something to think about when placing it in more of a enclosed area.

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Annette Tarbuk
9 months ago
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