![]() Conclusions: The epoc system is fit for use in the surgical and ICU setting for the measurement of all analytes except for creatinine. Creatinine showed the largest bias relative to laboratory analyzers, Abbott Architect c8000 Jaffe method (13.54%, 95% CI = 5.43, 21.65) and Roche Cobas c702 enzymatic method (30.01%, 95% CI = 12.64, 47.38). Hematocrit showed a bias of -6.76% (95% CI = -8.91, - 4.61) compared to the HemataSTAT-II method, whereas calculated total hemoglobin showed a bias of 1.51% (95% CI = -1.04, 4.06) against the Sysmex XN-10 hematology analyzer. Results: Mean bias was <5% for blood gases, electrolytes, lactate and glucose. ![]() Method comparison was performed for all analytes on the epoc System against the RAPIDPoint 500 Blood gas analyzer or laboratory analyzers where applicable. Using the iStat for these types of patients made a huge difference since we could determine how sick these patients were much quicker than if we had to wait for lab to send us the results and we could start treatment quicker.Venous or arterial whole blood samples collected in balanced heparinized syringes were obtained from 69 patients (35 females, 34 males) predominantly (77%) from the surgical unit and intensive care unit (ICU). We used the iStat for our critically ill or trauma patients and we also used it to get blood gases on our new diabetic patients to determine if they were in DKA. The bedside RNs were trained to use these as well as the RTs. I also worked in a pediatric ER for a while and we used the iStat there. Not only does the epoc not require a lot of blood, but also, we get the results very quickly. I love using this for our micropreemies who are on the vent since there are times that we are getting blood gases every couple hours. As adventure_RN said, this is typically used to get additional lab tests if we are already getting a blood gas, but we also will use the epoc just to get electrolytes or a hematocrit on some of our smaller babies just so we don't have to send so much blood down to the lab. We use this to run all of our blood gases and we don't send any blood gas samples down to the lab. Once the card is inserted into the reader, it takes a couple minutes for it to be ready for blood insertion, but once the blood sample is inserted, the results are available in 30 seconds. There is only one card to insert and then you can choose from all of these different test options. Bedside RNs are taught how to use the epoc and we can test blood gases, electrolytes, glucose, hematocrit, lactate, and creatinine. It works similarly to the iStat and also requires just 0.1mL of blood. My unit uses a different bedside lab analysis system called epoc ( epoc® Blood Analysis System - Alere). An unstable intubated baby may get ABGs every few hours, a kid with screwed up electrolytes may get lytes every day, and a chronic former 25-weeker may get a crit, retic and lytes once a week. ![]() The frequency of labs is entirely dependent on the baby. In my first NICU job, all I knew was that the RT ran the 'blood gas machine.' I didn't know how it worked, and I had no idea that it could also analyze crit, lytes, lactate and glucose. I'm sure many NICU nurses don't even realize that these devices are being used on their units if their blood gases are run by RTs. Our POC department told us that the results the same quality as lab-sent samples, but some providers don't feel that way and will occasionally send follow-ups of the same test to the lab to corroborate the iStat results. I'd imagine they're used much more often in ICUs and the ED, where rapid results are crucial. I'm guessing they aren't used very often on other units because they're expensive. A CG8 panel (our most common cartridge) requires 0.1 mL of blood and runs a gas, a crit/hemaglobin, electrolytes, and blood glucose. So for instance, there is a cartridge that runs only electrolytes, but we never use it however, there's another cartridge that has a gas + electrolytes which we use all of the time. The additional lab values can be added on if you're already planning to get a gas, but the iStat isn't used unless a gas is indicated. On my unit, the primary function for the device is point of care ABG analysis. They make several different cartridges that have different capacities (so if you need a gas you'd pick the gas cartridge, if you need a lactate you'd pick the lactate cartridge). Here's a list of every test that we can run. ![]()
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