pCO2 Proficiency Failures with the RapidPoint 500
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Our Respiratory Therapy department has had 3 API proficiency failures for the pCO2 on the RapidPoint 500. We have ceased pCO2 test on the RapidPoint and have switched over to using the CG4+ and the CG8+ on the i-STAT. We have had Siemens involved in coming out to check out the instrument and everything appears perfectly fine. The RT staff have all been retrained and have shown to be competent.
The first API survey of 2022 was passed 100%. Event 2 for this year, the pCO2 once again failed. Staff performing the survey were closely watched to make sure that the instructions for performing the test were strictly followed.
Our next survey is due to be shipped August 22. We are also going to order a CAP survey to run along side of the API survey. We have even considered ordering a second API survey to run on another analyzer (thinking that perhaps our primary RapidPoint is nearing its end of life).
Has anyone had this type of issue in the past?
Are we maybe overlooking something?
Could it perhaps be the integrity of the PT samples?
We would welcome some suggestions and/or guidance.
The first API survey of 2022 was passed 100%. Event 2 for this year, the pCO2 once again failed. Staff performing the survey were closely watched to make sure that the instructions for performing the test were strictly followed.
Our next survey is due to be shipped August 22. We are also going to order a CAP survey to run along side of the API survey. We have even considered ordering a second API survey to run on another analyzer (thinking that perhaps our primary RapidPoint is nearing its end of life).
Has anyone had this type of issue in the past?
Are we maybe overlooking something?
Could it perhaps be the integrity of the PT samples?
We would welcome some suggestions and/or guidance.
3 Replies
This used to happen on my GEM 4000 but since I've upgraded to the GEM 5000 the cartridges work much better and seem more stable. We are at over 7,000 ft elevation so peer studies always failed the pCO2 for this reason, I believe. We never had an instrument fail twice in a row, luckily, but look into temperature and elevation as for reasons why it may be very sensitive. If it is failing peer studies, but passing QC, Calibration looks fine, etc. you may have your pathologist look into it as well and continue using it.
How does you pH look? I seem to remember that if samples get frozen (too close to back of fridge, etc), the CO2 can precipitate out as calcium carbonate. And usually pH and pCO2 are effected by similar circumstances. I'm sure someone out there knows this stuff better than I do, but thought I'd throw this out there to get "them" thinking about this!
I have had a lot of problems with API with their testing specimens and possible contamination. We did great with all of our 2021 molecular covid proficiency testing. We failed a survey because we test dry swabs and they wouldn't send us a swab that wasn't in VTM. After hours with technical support they sent us different swabs for our 2nd survey. This time a dry foam swab when we need a dry flocked nylon swab. Their response, "That's what we send everyone and we can't change the swab." They are refusing to send us an appropriate swab and I think we are going to fail again because we cannot submit a result of inappropriate sample type. After this fiasco we are changing companies.
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