Neonatal Potassium and Arterial Blood Gas Testing

This consideration fell out when we did our IQCP plan for the EPOC. We track and investigate any cap k's over a certain value. And try to identify any trends associated with the users via chart review. In the beginning this helped fine tune the collection process for everyone in order to minimize events now it is used to catch any fallouts. If they have a corresponding bili from the same heelstick is about the only way we find out if there was any true hemolysis. We have not had any problems with elevated K's but we do see them. Education on these limitations and communication with the whole neo team is a must. I don't know about drawing up heelstick blood in a syringe. The epoc has buffered hep capillary tubes with a syringe like action. 

Terri - I have one off site NICU that uses the CG8 with art, ven and cap samples. The capillary draws took patience and education about technique but once they got more experienced, the hemolyzed samples were greatly reduced. That site uses the Sarstedt minivette 100uL lithium heparin capillary device. This collect just enough volume for the cartridge and has a plunger to push the sample out. The staff love these collection devices - they work much better than trying to use a traditional capillary tube. 

481_d_Minivette_GB_1112 (1).pdf

Hi Terri
We use the EG7 in our NICU for capillary samples, especially now that we can't do cap samples on CG4/Chem8 combo that we use in most of the other Istat areas.  The nurses collect the samples and use the Safe Wrap capillary tubes by RNA for our heel sticks in NICU, PICU or CICU.  We have been using heelsticks almost as long as we have been doing Istats so the units are used to the discrepancies between the heel stick and line values.