Thanks for sending me the data provided by the manufacturers and importers.
I'll copy my response to the list
The US instructions do not refer to the use of capillary blood; they refer
to either serum or whole blood collected with an anticoagulant. What happens
when capillary blood is taken and clots in the sample well? The UK importers
instructions refer to the use of 4 droplets of whole blood, origin
unspecified.
The sensitivity reported in John Henry's abstract from the November 2001
meeting of the Faculty of A&E medicine refers to a sensitivity such that
with a serum paracetamol of 2 mg/l the device showed "100% sensitivity".
Hmm. Lot of room for false positives if you are trying to differentiate
therapeutic use of paracetamol from overdose there.
Specificity may be an issue. The US data sheet shows high cross reactivity
with Bezafibrate.
Does it cross react with glucuronides, or just react with free paracetamol?
Lots of issues here for the UK importers to address.
Finally; does it really save time? if someone comes into an A&E dept saying
they have taken an overdose and a screening test for salicylates and
paracetamol is negative, isn't there still going to be a bit more
interaction with the caring professions than just showing them the door? Why
not get the test done properly if you have to venepuncture them anyway as
the US data sheet suggests?
Best
Robert Forrest
-----Original Message-----
From: Clinical biochemistry discussion list
[mailto:[log in to unmask]]On Behalf Of Eric Hindle
Sent: 11 September 2003 08:51
To: [log in to unmask]
Subject: NPT for paracetamol/salicylate
In A/E departments, waiting time targets are pretty tight and we have been
working with our A/E to look at possible ways of speeding the throughput of
OD patients. This has been 'stimulated' to some extent by an approach to
A/E to consider using a rapid test strip (EUROMED DIAGNOSTICS) which
produces results 'within 5 to 8 minutes(negative results may appear
sooner)'.
The representative has told A/E staff that 'it can detect paracetamol
within 20 minutes of ingestion'.....(but can't provide me with the
evidence); this doesn't make much sense to me.
I have been provided with a list of users (including my own hospital!!!
where it has been looked at very briefly but is certainly NOT 'in use').
Some other listed users are the Royal London, Maudsley Hospital, Northwick
Park, Lewisham, St Helier, Wexham Park, St Mary's Paddington, Charing
Cross, Southampton and several hospitals in Ireland. I wonder if this
information is correct and are the laboratories there aware of this, is it
just the A/E departments working independently, or is it just spin?
Does anyone have experience of this kit? Are the companies claims correct?
Should we be going down this route at all, (and I realise this has been
discussed previously)?
Eric Hindle
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------ACB discussion List Information--------
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community working in clinical biochemistry.
Please note, archived messages are public and can be viewed
via the internet. Views expressed are those of the individual and
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