Sorry, I meant neonatal requestss from eg midwives seeing babies at
home... need for small specimens, but clinicians not near a blood gas
analyser...
Best wishes
Jonathan
On Friday, November 22, 2002, at 01:08 PM, Fry, John wrote:
> Jonathan
>
> Requests for biblrubin assays from non neonatal wards are analysed on
> the
> Roche Modular for total bilirubin and on the Roche Integra for direct
> bilirubin. Approximately 175 uL of serum is required for both assays.
>
> Best wishes
>
> John Fry
>
>
>> ----------
>> From: Jonathan Kay[SMTP:[log in to unmask]]
>> Reply To: ACB Point of Care Testing List
>> Sent: 19 November 2002 16:23
>> To: [log in to unmask]
>> Subject: Re: Bilirubinometers
>>
>> Using the blood gas analysers is attractive. How do you handle the
>> requests for bilirubin analysis that come from sources other than the
>> neonatal unit? Have a blood gas analyser in the laboratory, or some
>> other approach?
>>
>> Dr Jonathan Kay
>>
>>
>> On Friday, November 15, 2002, at 05:43 PM, Fry, John wrote:
>>
>>> All samples on SCBU that are analysed for blood gases automatically
>>> have a
>>> bilirubin result. Yes, the problem was I believe in one of the
>>> mathematical
>>> formulae used to 'produce' a bilirubin result.
>>>
>>> Prior to purchasing this machine, we did look at a number of
>>> 'bilirubinometers' but, since the blood gas machine on SCBU was
>>> almost due
>>> for replacement, combining the two instruments was the most cost and
>>> clinically effective method of progress.
>>>
>>> John Fry
>>>> ----------
>>>> From: PETER HOWELL[SMTP:[log in to unmask]]
>>>> Reply To: ACB Point of Care Testing List
>>>> Sent: 15 November 2002 15:34
>>>> To: [log in to unmask]
>>>> Subject: Re: Bilirubinometers
>>>>
>>>> Hi John
>>>>
>>>> The potential 'controversy' was over the performance of bilirubin on
>>>> the
>>>> analyser, not the use of the analyser for one-off bilirubin
>>>> measurements.
>>>> This would not seem to be apparent from your experience, but I
>>>> remember
>>>> some doubts from somewhere. I'll search my 'memory banks' !
>>>> Would your SCBU staff use the blood gas analyser to do JUST a
>>>> bilirubin,
>>>> or would they measure blood gases/electrolytes at the same time,
>>>> even
>>>> if
>>>> the baby didnt require them ?
>>>> Do you see what I mean ??
>>>>
>>>> Peter
>>>>
>>>>
>>>>> -----Original Message-----
>>>>> From: Fry, John [SMTP:[log in to unmask]]
>>>>> Sent: 15 November 2002 15:30
>>>>> To: [log in to unmask]
>>>>> Subject: Re: Bilirubinometers
>>>>>
>>>>> As far as the analytical side goes, our NEQAS returns are good, as
>>>>> is
>>>> the
>>>>> correlation with the main analysers in the department. Neither the
>>>> technical
>>>>> staff or myself are aware of the controversy you have mentioned
>>>> regarding
>>>>> one off bilirubin in sick neonates.
>>>>>
>>>>> John Fry
>>>>> Clinical Biochemist
>>>>>
>>>>>> ----------
>>>>>> From: PETER HOWELL[SMTP:[log in to unmask]]
>>>>>> Reply To: ACB Point of Care Testing List
>>>>>> Sent: 15 November 2002 13:18
>>>>>> To: [log in to unmask]
>>>>>> Subject: Re: Bilirubinometers
>>>>>>
>>>>>> Isn't there some 'controversy' about how good these analysers are
>>>>>> at
>>>>>> measuring bilrubin ??
>>>>>>
>>>>>> And its OK if you are also measuring blood gases/ electrolytes at
>>>>>> the
>>>> same
>>>>>> time, but not really for just a one-off bilirubin on a 'well'
>>>>>> baby.
>>>>>>
>>>>>> Peter
>>>>>>
>>>>>> Peter Howell
>>>>>> Head Biomedical Scientist
>>>>>> Medical Biochemistry Department
>>>>>> Wrexham Maelor Hospital
>>>>>> Wrexham
>>>>>>
>>>>>>
>>>>>>> -----Original Message-----
>>>>>>> From: Fry, John [SMTP:[log in to unmask]]
>>>>>>> Sent: 15 November 2002 13:16
>>>>>>> To: [log in to unmask]
>>>>>>> Subject: Re: Bilirubinometers
>>>>>>>
>>>>>>> One possible answer is to purchase one of the Radiometer 7 series
>>>> blood
>>>>>> gas
>>>>>>> analysers which incorporates an analytical uniit for bilirubin
>>>> assays on
>>>>>> the
>>>>>>> whole blood sample. Centrifugation of capillary samples is then a
>>>> part
>>>>>> of
>>>>>>> history.
>>>>>>>
>>>>>>> John Fry
>>>>>>> Worthing Hospital
>>>>>>>
>>>>>>>> ----------
>>>>>>>> From: Evans, Francis -
>>>>>> RCHT[SMTP:[log in to unmask]]
>>>>>>>> Reply To: ACB Point of Care Testing List
>>>>>>>> Sent: 15 November 2002 11:58
>>>>>>>> To: [log in to unmask]
>>>>>>>> Subject: Re: Bilirubinometers
>>>>>>>>
>>>>>>>> I have been concerned for 'ages' about the infection risk
>>>>>>>> involved
>>>> in
>>>>>>>> spinning capillaries for bilirubins in our SCBU laboratory. We
>>>>>>>> do
>>>>>> have a
>>>>>>>> separate lab to contain the gas analyser and bilirubinometer but
>>>> the
>>>>>>>> aerosol
>>>>>>>> problem when capillaries leak and eject their contents is of
>>>>>> considerable
>>>>>>>> concern. I have not been able to get any manufacturer to
>>>>>>>> supply a
>>>>>>>> properly
>>>>>>>> sealed rotor to contain spills.
>>>>>>>>
>>>>>>>> I would also be interested to hear other views on suitable
>>>>>> alternatives.
>>>>>>>>
>>>>>>>> Francis Evans
>>>>>>>> Chief BMS
>>>>>>>> Clinical Chemistry
>>>>>>>> Royal Cornwall Hospitals Trust
>>>>>>>> Truro TR1 3LJ
>>>>>>>>
>>>>>>>>
>>>>>>>>
>>>>>>>> -----Original Message-----
>>>>>>>> From: Paul Eldridge [mailto:[log in to unmask]]
>>>>>>>> Sent: Friday, November 15, 2002 10:05
>>>>>>>> To: [log in to unmask]
>>>>>>>> Subject: Bilrubinometers
>>>>>>>>
>>>>>>>>
>>>>>>>> I have sent this to both the POCT list and ACB clin chem list.
>>>>>> Apologies
>>>>>>>> to those who get it twice.
>>>>>>>> Two problems/questions:
>>>>>>>> 1. Infection in ward areas by centrifuges.
>>>>>>>> It has been reported by a new paediatric doctor here that
>>>>>>>> bilirubinometers have been removed from wards in 2 SW London
>>>> hospitals
>>>>>>>> because of infection risks from the centrifuges used to spin
>>>>>>>> down
>>>> the
>>>>>>>> capillary tubes.
>>>>>>>> Have others experienced this problem?
>>>>>>>> Is there a centrifuge available that can be sealed?>
>>>>>>>> Is there any good experience with non invasive bilirubin
>>>> measurements?
>>>>>>>>
>>>>>>>> 2. We recently replaced our TIME ward bilirubinometer with the
>>>> Digital
>>>>>>>> Analogue Systems NEO BIL instrument distributed by Schuco in the
>>>> UK.
>>>>>> It
>>>>>>>> very simple to operate by the ward staff but cannot be
>>>>>>>> calibrated
>>>> by
>>>>>> the
>>>>>>>> lab. It has a non linear response noted by positive bias below
>>>>>>>> 300
>>>> and
>>>>>>>> negative above this level. This has been shown by studies on
>>>>>>>> EQAS
>>>>>>>> samples and our dilution studies.
>>>>>>>> Do others have the problem and how do you overcome it ?
>>>>>>>>
>>>>>>>> Many thanks in advance.
>>>>>>>>
>>>>>>>>
>>>>>>>> Dr Paul H Eldridge
>>>>>>>> Clinical Biochemist
>>>>>>>> University Hospital Lewisham
>>>>>>>> London SE13 6LH
>>>>>>>> UK
>>>>>>>> Phone: (44) 020 8333 3255
>>>>>>>> Fax: (44) 020 8690 8891
>>>>>>>>
>>>>>>>>
>>>>>>>> [log in to unmask]
>>>>>>>>
>>>>>>>>
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