Blood gas analyzer basics, —and beyond
September 2002 Raymond D. Aller, MD
Twenty-five blood gas analyzers from eight vendors are profiled on
pages 64-88. For each analyzer, we list everything from how the operator is identified
to the sampling technique and the sample size for a panel of results.
The vendors of these systems supplied the information by answering
CAP TODAY's questions.
Analyzer technology continues to evolve, moving more of the capabilities
of the acute-care laboratory closer to the patient's bedside. Devices
that originally provided only measurements of blood gases can now
determine other critical-care analytes. In addition to the traditional
"chem-7," some of these analyzers provide calcium, magnesium, bilirubin,
lactate, or coagulation (PT, PTT, ACT) determinations, or some combination
thereof.
Data-management capabilities have also progressed. The most crucial
of these is positive patient identification. All but three of the
devices profiled in this issue include bar-code readers that provide
reliable, error-free confirmation of patient identification at the
bedside.
The rate of medical errors has caused great concern, and the most
serious of these errors is performing procedures on the wrong patient.
As laboratory professionals, we have an obligation to ensure that
test results are reliably linked with the correct patient. Positive
identification of the patient at the bedside is the most crucial
step.
Connectivity between analyzers and laboratory information systems
is improving, too. Now that the point-of-care connectivity standard,
developed by the Connectivity Industry Consortium, has been adopted
as an NCCLS Standard (POCT-1A), more standard and comprehensive
interfaces will strengthen this connection.
Each of the vendors listed on the survey pages has continued to
build their analyzers' internal data-management capabilities-or
an attached data manager-yet it is challenging for hardware-focused
vendors to build into their systems a full range of sophisticated
quality control and user-monitoring functions. At the same time,
hospitals are recognizing that they need to connect point-of-care
devices from several different vendors, and they want to manage
these devices in a coherent fashion. Therefore, third-party systems
for collating and managing devices from a variety of vendors are
emerging. Medical Automation Systems and Telcor are among the vendors
in this device-integrator market.
We urge CAP TODAY readers to talk to existing users of these devices
to assess how vendors handle installation and support of their systems.
Are service calls fulfilled in a timely manner? Are problems responded
to appropriately?
Dr. Aller is based in Vista, Calif., and can be reached at raller@earthlink.net.
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