RT spoke with leading diagnostic manufacturer Nova Biomedical about some industry trends in blood gas analyzers and how devices are meeting clinical demands.
For diagnostics like blood gas analysis, there is always a need to balance demand for fast, convenient testing with safe, accurate results. To learn more about how companies are achieving this balance with their products, this month, RT talked to Nova Biomedical Inc and product manager Brad Bullen, BS, RCP.
RT: Tell us about your company’s most recent products and what features and advantages do today’s blood gas analyzers offer over previous generations?
Brad Bullen: Nova Biomedical’s most recent product is the Stat Profile Prime Critical Care System (CCS). The current point-of-care marketplace demands more for less. More analytes, greater uptime or sample throughput, and zero maintenance, all with a lower overall cost. Our component cartridge design optimizes the life of each component and maximizes the overall value of each component. This design also minimizes the overall downtime associate with older cartridge based systems.
The Prime also introduces “Clot Block” technology to the Stat Profile product line. This technology mitigates the risk of introducing clotted material to more sensitive areas of the sample flow path. If a clot is detected a simple back flush process allows for the end user to be sample ready in less than five minutes.
The Stat Profile Prime was designed with my fellow respiratory therapists in mind. We need clinicians to be at the bedside, not working on diagnostic instrumentation.
RT: What are the most important things RTs should be aware of when collecting samples for today’s devices? Are there any precautions RTs should take in order to get the best results?
Bullen: Collecting a sample can be the most challenging step in the process. Most errors in the analysis of gases and electrolytes in arterial blood samples are due to preanalytic factors. Sample collection and handling of that sample are key to accurate analysis. Elimination of air bubbles and short time to sample analysis is paramount. That patient sample continues to change following collection. Providing sample analysis immediately following collection assures the most relevant patient results.
RT: Accurate interpretation of arterial blood gas readings is important, so what types of support do your companies have in place to help clinician training and ensure testing accuracy?
Nova Biomedical has operated in the critical care diagnostics niche for nearly 40 years. Training, implementation and analyzer support are all administered by dedicated Nova employees. We provide online technical support 24 hours a day, 365 days per year, free of charge.
RT: What are your thoughts on the industry’s push towards point-of-care testing and what advantages do bedside analyzers offer to RTs?
Bullen: Analysis that takes place closer to the patient makes sense. That said, we should not jeopardize quality and accuracy for the sake of convenience or speed to result. If the analyzer is not calibrated correctly or reports inaccurate results what good is having it bedside? New regulatory guidelines have been introduced to help maintain accuracy and quality for diagnostic analyzers. Having an analyzer that meets or exceeds these new guidelines with the least impact to respiratory care workflow is optimal.
RT: A 2015 study from Cleveland Clinic indicated that frequent blood gas testing resulted in excessive bloodletting, which increased cardiac patients’ risk of hospital-acquired anemia and need for transfusion. How often should patients’ ABG be tested, and does it vary widely based on their disease or condition?
This is a challenging question. In my opinion; there is not one answer that applies across all hospitals or ICU’s. A level 3 NICU has a different diagnostic need than say an emergency room. One thing we can all agree upon is excessive testing is something we should avoid. The clinical acuity and patient care team should adjust according to need.
RT: When asked what features they would like to see in the next generation of ABG testing devices, RTs have cited: improved wireless technology, hands-free sample aspiration, improved interfaces, enhanced durability, and reduced sample size requirements. Do you believe the industry can respond to these clinical needs and help improve testing efficacy and patient management/diagnostics for clinicians?
Bullen: The next generation of analyzers will need to continue to adapt to meet the needs of the current and future patient care environments. A common mistake make by diagnostic manufacturers is the design of instrumentation without the end user in mind. Making it simple to operate without much instruction and providing clinically accurate results is the absolute minimum expectation. Hands-free operation and sample introduction not only offers convenience but minimizes the additional risk of biohazard exposure.
Conveyance of sample result to the clinician or hospital database requires a degree of analyzer connectivity. Wireless is a good concept but there remains many unforeseen challenges with blood gas, electrolyte connectivity in the hospital. Moving an analyzer from unit to unit, bedside to bedside offers a unique challenge from a connectivity perspective but decontamination as well. These challenges are where the hospital and manufacture need to work together to better understand the environment and needs of the care team.
One major challenge that will be faced by RT departments is compliance to the new EP23-A quality control guidelines. These new guidelines require some action taken by respiratory staff depending on location of instrumentation and how it is operated. EP23-A and its impact on point-of-care testing will continue to evolve. Nova Biomedical has worked hard to minimize the impact of this through innovation and technology. RT