Blood Gas analysis

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We are a CAP accredited hospital. Our OB department has requested to do blood gas analysis for their critical babies. I am aware of the iSTAT but wondered if any of you are utilizing any other point of care analyzer for this purpose? If so what is it, do you like/not like it, etc. Thanks for your help!

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Hi Ashlee. We are CAP accredited as well, and we use the Siemens EPOC analyzer for blood gas testing in the NICU as well as elsewhere throughout our hospital. One key difference between iSTAT and EPOC is that with EPOC, there's a 3-minute calibration BEFORE the blood is injected into the system. With iSTAT, the cartridge calibration occurs AFTER you present the blood sample. Our NICU RT team prefers the EPOC workflow because if the calibration fails, they haven't wasted their precious blood sample. Just one factor to consider. Also, EPOC cards have all the tests on the same card rather than spread across multiple different cartridges, and they're stored at room temperature which makes inventory control easier. Good luck with your decision!

Hi, I'm JC accredited and have the EPOC. Everything Christina says is our system as well. 

We use the Epoc at one of our hospitals for the NICU.  The workflow is one factor for choosing it over i-STAT; but another is the room temp storage of the test cards. At another of our hospitals, we're using the RapidPoint 500e in the NICU, doing blood gas but also electrolytes and glucose (and many combinations of those!). It works really well for the high volumes we have. For smaller volume sites, an i-STAT or Epoc makes better sense in terms of cost. For higher volume sites, a blood gas analyzer like RapidPoint or GEM 5000 is more economical. And your middleware might make a difference for what you choose.

We are CAP accredited & use the epoc for adults and infants.  I echo Christina's comments also.

Thank you for the info! Can you give me the basics of the EPOC? How often is QC run? Is there electronic QC and liquid? It connects to RALS? How many cards come in a pack? We would be a lower volume site. 

We run liquid QC monthly.  There are 50 cards per box.  The electronic QC runs automatically on the instrument.
Ours connects to the Siemens Data Manager, then to our LIS.  I believe it also will connect to RALS.

Yes, the EPOC connects to RALS too. Our cards come 25/box (we use the orange ones). We also run liquid QC monthly, as well as on each new shipment of cards.

We also use EPOC thru RALS. Works great and we like not having to worry about warming up cartridges since the cards are kept at RT. The difference between the 50 ct box (green cards) and the 25 ct box (orange cards) is that the orange cards will give you a BUN and Total CO2, so effectively you are getting a BMP and your blood gases, lactic acid, ionized calcium.

We are the same as many of the folks here - CAP accredited facility; 25 cards/box (orange cards); monthly liquid QC (and with new lot shipments); and connect to Rals - so far so good, and we are almost 2 years into it!  My biggest concern was with the learning curve for the sample introduction since it is a direct injection - I was certain I would have to replace many readers for blood/QC getting inside the reader due to careless injections, but my operators have been amazing!  I really stressed with the initial introduction and training that they need to use a gentle touch and let up immediately when they hear that beep, and they seem to be doing well with it.  Their biggest complaint is the almost 3 minute calibration prior to sample introduction, but I've explained to them that it helps to not waste a blood sample if something is going on with the test card.  I used to get complaints about this a lot when we first started using it because they were used to the istat, but the complaints are not very frequent anymore.  Overall, I really love the Epoc an am glad we made the switch.

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Ashlee Byquist
about 3 years ago
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