Very few of these appear, but there is normally sufficient blood to
undertake the analysis on the standard anlysers noted in the earlier e-mail.
No overt problems have arisen with this procedure.
John Fry
> ----------
> From: Jonathan Kay[SMTP:[log in to unmask]]
> Reply To: ACB Point of Care Testing List
> Sent: 22 November 2002 13:58
> To: [log in to unmask]
> Subject: Re: Bilirubinometers
>
> 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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