i-Stat troubleshooting - Point of Care Testing

Page 1 of 3Durham Regional HospitalPolicy & Procedure ManualSUBJECT: i-STAT TROUBLESHOOTINGDATE EFFECTIVE: 06/97 DATE REVISED: 02/12REVIEWED BY: Susan Montsinger APPROVED BY: Maureen Bauer, M.D.PurposeTesting locations should have a functioning analyzer available when i-STAT testing is requested.If a functioning analyzer is not available, locations will request alternate testing.Analyzer Coded MessagesIf a problem is detected during a testing cycle, the cycle will be stopped and a message box willappear on the display. The messages will identify the problem and indicate the next step to betaken. If the analyzer deactivates before the detected problem is addressed, the message box willreappear the next time the display key is pressed. Below the message box is a code #. Thisnumber may be helpful if a problem cannot be resolved. Attached are messages that may displayand the action to be taken.Repeat the test. If the coded message appears again, contact Laboratory Point of Care Testing(POCT), (470-8257), or the Respiratory Therapist on call for blood gases for assistance.Analyzer MalfunctionIf an analyzer is not working, contact Laboratory POCT, (470-8257), or the Respiratory Therapiston call for blood gases for assistance.Analyzer ReplacementWhen a location needs an analyzer to replace one that is malfunctioning, Laboratory POCT, orRespiratory Therapy will remove an analyzer from another location.If an analyzer must be is removed, the location will be notified:LocationPerson NotifiedEDCharge NurseAnesthesia Anesthesia Workroom TechnicianCCUCharge NurseCath LabCharge Nurse52 Charge Nurseist troubleshoot

Page 2 of 3NurseryRadiology CT/MRICharge NurseNotify CT technologistAnalyzers should first be removed from locations having multiple analyzers:Location InstructionsEDremove ER Non Acute analyzerCCUremove 1 analyzerAnesthesia If there is no CPB case scheduled, remove 1 analyzerCath Lab If both rooms do not have a case scheduled, remove 1analyzerMultiple Analyzer MalfunctionIf multiple analyzers are malfunctioning, Laboratory POCT, or Respiratory Therapy will removefunctioning analyzers from non acute areas and take them to acute areas.Analyzers will be removed in the following order:Location InstructionsEDremove ER Non Acute analyzerCCUremove 1 analyzerAnesthesia If there is no CPB case scheduled, remove 1 analyzerCath Lab If both rooms do not have a case scheduled, remove 1 analyzerRadiology MRI Radiology MRI will share Radiology CT analyzerNursery Nursery will page Respiratory Therapy if a blood gas is needed52 52 will page Respiratory Therapy if an ACT is neededAlternate TestingBelow is the alternate testing available if a malfunctioning analyzer cannot be replaced:AnalyteInstructionsSodium, Potassium, Chloride, BUN, Glucose, Request needed STAT laboratory test.Hematocrit, Hemoglobin, CreatinineRadiology: Request STAT Creatinine using the“Laboratory Order Sheet from Radiology”form. Collect a lithium heparin green top tubeand deliver it to Laboratory SpecimenManagement.Blood gasesSpecimens will be sent to DUH Blood Gas Labby STAT courierIonized CalciumSpecimens will be sent to DUH Blood Gas Labby STAT courierist troubleshoot

Page 3 of 3ACTRequest STAT laboratory Prothrombin Time(PT), and PTT, APTT Plasma/WH BLDReference:iSTAT System Manual, revised September 2008. The iSTAT Corporation, Princeton, New Jerseyi-STAT Technical Bulletin, revised September 2010. Abbott Point of Care Inc. Abbott Park, IL60064.Procedure Written By: Kathryn Winston, 6/97Procedure Revised By: Kathryn Winston, 7/98,6/01, Susan Montsinger, 5/04, 06/09, 06/10, 02/12Procedure Reviewed By:________________________________ __________________________________Maureen Bauer, M.D. Date Mark Powers, M.D. DateSection PathologistDirector of Respiratory Therapy________________________________Susan Montsinger BS, MT(ASCP) DatePoint of Care Coordinator_________________________________Charles Alford, RRTDirector of Cardiopulmonary Servicesist troubleshoot