 |
 |
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] >>>>>> >>>>>> >> ********************************************************************** >>>>>> DISCLAIMER: >>>>>> >>>>>> Any opinions expressed in this email are those of the individual >> and >>>>>> not necessarily the Trust. This email and any files transmitted >> with >>>>>> it are confidential and intended solely for the use of the >> individual >>>>>> or entity to whom they are addressed. Any unauthorised disclosure >> of >>>>>> the information contained in this e-mail is strictly prohibited. >>>>>> >>>>>> The contents of this email may contain software viruses which >> could >>>>>> damage your own computer system. Whilst we have taken every >>>>>> reasonable precaution to minimise this risk, we cannot accept >>>> liability >>>>>> for any damage which you sustain as a result of software viruses.> >>>>>> You should therefore carry out your own virus checks before >> opening >>>>>> the attachment. >>>>>> >>>>>> If you have received this email in error please notify the sender >> or >>>>>> [log in to unmask] Please then delete this email. >>>>>> >>>>>> University Hospital Lewisham >>>>>> Tel: 020 8333 3000 >>>>>> Web: http://www.lewisham.nhs.uk/ >>>>>> >> ********************************************************************** >>>>>> >>>> >> ---------------------------------------------------------------------- >> ---- >>>>>> -------------------------- >>>>>> The information in this e-mail and any attachments is confidential >>>>>> and is intended for the attention and use of the named >>>>>> addressee(s). It must not be disclosed to any other person >>>>>> without our authority. If you are not the intended recipient, or >> a >>>>>> person responsible for delivering it to the intended recipient or >>>>>> are aware that this e-mail has been sent to you in error, you are >>>>>> not authorised to and must not disclose, copy, distribute, or >>>>>> retain this message or any part of it. >>>>>> >>>>>> We sweep all outgoing mail for the presence of computer >>>>>> viruses. However we cannot accept any responsibility for any >>>>>> loss or damage to your systems due to viruses or malicious code >>>>>> not detected. >>>>>> >>>>>> The statements and opinions expressed in this message are >>>>>> those of the author and do not necessarily reflect those of the >>>>>> organisations within the Cornwall & Isles of Scilly Health >>>>>> Community, which will not automatically take any responsibility >>>>>> for the views of the author. >>>>>> >>>> >> ---------------------------------------------------------------------- >> ---- >>>>>> ------------------------- >>>>>> >>>> >>