Hi Debbie,
We have had similar issues on our labour ward/neonatal unit/Transitional care unit. Yes we did introduce clot catchers and incidence of cases have reduced but not completely eradicated. The clot catcher introduction was not without its own issues as the users will need to take a slightly larger volume or else have another error - 'Insufficient sample' created when samples are analysed. The additional sample size is to take care of the dead space at the end of the attached clot catcher.
Uche Okeahialam
Advanced Biomedical Scientist | POCT Section, Blood Sciences
Pathology | BRI
Bradford Teaching Hospitals NHS Foundation Trust
T: 01274 36 4196
http://www.bradfordhospitals.nhs.uk
-----Original Message-----
From: ACB Point-of-Care Testing [mailto:[log in to unmask]] On Behalf Of Debbie Gooseman
Sent: 03 January 2020 11:28
To: [log in to unmask]
Subject: Re: Blood gas sampling- viscous sample problems
Hi Tony,
In each instance there has been no concurrent FBC received by the laboratory. They tend to be foetal or neonatal samples where large sample volumes are difficult to obtain and (certainly in terms of monitoring where several repeat samples are required) not practical.
The error codes encountered tend to be positioning errors, and have been fully investigated by the supplier.
Sample quality issues cannot be ruled out entirely, but we have experienced staff of the unit who state the samples were as ‘good’ as possible in terms of size and mixing. Analyser logs back up their assertion that volumes introduced to the analyser should have been adequate.
Vaseline has not been used for sample collection.
As Terri Robinson has stated, the Roche workaround is to introduce a clot catcher. Has anybody successfully introduced clot catchers (or any other such measures)? I am sceptical as to how putting another ‘obstacle’ in the flow path of a viscous sample can help!
These are invariably ‘precious’ and difficult to collect samples, and if there is anyway we can support the unit to get reliable results then we’d like to do so!
Debbie Gooseman
POCT Coordinator
NLaG NHS Trust
Sent from my iPhone
> On 3 Jan 2020, at 09:38, CAMBRIDGE, Anthony (UNIVERSITY HOSPITALS PLYMOUTH NHS TRUST) <[log in to unmask]> wrote:
>
> Hi Debbie
>
> Happy New Year to you.
>
> Was the haematocrit known on any the patient samples you had difficulty with? Extremely high haematocrit levels may interfere with analysis but the b123 seems to have a wide measuring range for hct 10-75%. Maybe a blood count sent to the lab around the same time would give you some info to go on?
>
> Other than that, the usual causes around sampling could be the problem especially with foetal samples - prolonged sampling, difficulty mixing thoroughly etc. What error codes were seen when attempting to analyse the samples? Clots, bubbles, inhomogenous sample.....
>
> Regards
>
> Tony Cambridge MSc., BSc., Prince2
> Lead Biomedical Scientist
> Blood Sciences and POCT
> Derriford Combined Laboratory
> University Hospitals Plymouth NHS Trust
> T: 01752 430050
> E: [log in to unmask]
>
> Keep Communicating
>
> Put patients first * Take Ownership * Respect Others * Be Positive
>
> -----Original Message-----
> From: ACB Point-of-Care Testing [mailto:[log in to unmask]] On
> Behalf Of Debbie Gooseman
> Sent: 03 January 2020 09:24
> To: [log in to unmask]
> Subject: Blood gas sampling- viscous sample problems
>
> Dearest mailbase contributors.
>
> Happy New Year!
>
> Can I please ask if anyone has had any experience of difficulties obtaining results from their blood gas analysers when using capillary sampling of viscous blood?
>
> Specifically the Cobas b123?
>
> We have encountered some issues with foetal and newborn samples, and were wondering if the wider POCT community has experienced this and/or managed to resolve it.
>
> Warmest regards ,
>
> Debbie Gooseman
> POCT Coordinator
> NLaG NHS Trust
> [log in to unmask]
>
>
> Sent from my iPhone
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