MIcro sample in the Neonatal ICU

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We are long time iSTAT users ( ED, Adult ICU etc) but now we have a request for some type of micro samples for our NICU.  They currently use Radiometer for blood gases, and are wanting to decrease the chance of anemia driving by blood collection for other labs.  Anyone that can help me with a few questions, it would be greatly appreciated
1- Are you using any POC in your NICU?
2-What sample types/collection devices are you using if you use iSTAT?
3-Do you use cord blood for any testing?
4-Do you perform chemistries on your radiometer/Gem/ or any other blood gas analyzer?
5-Who performs testing? (other than capillary glucose)

Anything you wish you had  done  differently???
Thanks
Kim Ballister
Cone Health, Greensboro NC

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Hi Kim,

We don't currently use the istat in our NICU, but we did until last year - we used the Chem8 (Chemistry and H&H) and the G3+ cartridges.  We made the switch to the Epoc during the whole Abbott cartridge fiasco last year as it was the best alternative for our facility, and my operators are loving it!  With the istat and now with the Epoc, they are allowed to use venos, arterial, or capillary whole blood.  Siemens actually has a special capillary collection device that essentially turns the collection tube into a syringe, and maybe I'm weird, but it is the coolest thing to me!  With the istat, they used a normal capillary collection tube.  We do not use cord blood for testing.  The Epoc test card has Blood Gas, Chemistries, and H&H, and we use the full card in the NICU - when we used the istat, we used the Chem8 and G3+ cartridges.  For the NICU, the NICU nurses all go through training and competencies and are signed off to perform the testing (RNs & LPNs).  As for if there is anything I wish I had done differently - I can't really say.  I inherited the POCC position when the istat had been in place for a few years, so my operators were all pretty used to the ins and outs of it, and we didn't have major issues.  With the Epoc, everyone seemed to take to it well also, so I can't really complain - the transition went much better than I expected!  I hope this info helps you some!  Good luck with everything!

Jacqueline

We also use the EPOC in our NICU, purposefully for most of the reasons Jacqueline mentioned. The sample size is 90 uL, and with that amount they can get blood gases AND a BMP, AND an H & H all on one test card. Test cards are stored at RT so they are always ready. I was very happy we were already using it during the i-STAT crisis! If you do decide to go the EPOC route, consider using WSLH for your PT testing. We are about 2 users shy of having a nice peer group number for our EPOC PT and that would help us out!

Thanks Patricia and Jacqueline.  I think the key for EPOC is that you can use capillary sample, whereas the iSTAT chem 8 no longer allows capillary sample

We are a Children's Hospital with a large NICU. Blood gases, electrolytes, iCa and Lactate are run on an ABL 800 which takes venous, arterial, or capillary samples.  Lab techs run the ABL800.  iStat EG7+ cartridges are used in the ED, ECMO patients, and in our Fetal Health Center for PUBS and high risk deliveries. The iStat handheld is limited on sample types; Cord bloods and ECMO runs are run under Sample Type 'Other' and don't cross to patient charts. Nurses and RT staff run the EG7's.  We use Nova StatStrip glucose meters in NICU, too.

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Kim Ballister
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