Bed-side blood tests mean better care for kidney patients
Bundaberg in Queensland is well known for its ginger beer and rum but less well known for the commitment to patient care shown in the local renal unit. The Bundaberg Renal Unit services a large area within the Wide Bay district and offers haemodialysis, transplant services, chronic kidney disease care and support for home renal dialysis. Bedside blood tests have helped staff to improve patient care and reduce waiting times.
Carleen Ellis is the Renal Clinical Facilitator at Bundaberg; she described the i-STATTM portable blood analyser as being 'fantastic' for the unit since they began using it in March 2021.
Ms Ellis described several examples of how the i-STATTM system has benefitted patients and staff at the unit, firstly for providing fast results in a potentially life-threatening situation.
"Kidney dialysis patients don't clear toxins very well, and one of the big ones that can be life threatening is potassium. So, potassium affects muscles, and your heart is a very important muscle and if they get high potassium levels, the heart can actually stop working properly, and they can have sudden cardiac arrest.
When a patient of ours comes in, and they report to us that they've got jiggly legs, or they just don't feel right, they've got lethargy, palpitations any of those symptoms of hyperkalemia, we suspect their potassium could be high.
Previously we would send off a blood test, but we wouldn't know for a couple of hours what the result is. Now we get that patient in the chair, we use the i-STATTM system and CHEM8+ cartridge to get that potassium result within two to three minutes. Then we know exactly whether the problem we're looking at is hyper-kalemia or if it's something else, and we have to investigate further.
For us that's a major thing, if they've got a really high potassium and we know that straight away, we can actually reduce the dialysate down to a low potassium. It enables us to actually change their treatment if we need to, rather than waiting two hours into treatment to get those results."
Getting urgent blood gas results in the past was time and labour intensive; once the blood sample was taken a staff member would run the sample over to a neighbouring unit to get the test performed and then run the results back to the renal unit. This was taking staff away from important duties but using the i-STATTM system means that staff can now stay with their patients.
"We're able to do that right there where the doctors are and get that result within a couple of minutes, so it saves losing that staff member in those critical situations."
Coagulation studies is another function of the i-STATTM system that the renal team have found useful to know when it is safe to remove a central line for patients undergoing procedures.
The team had no problems learning to use the analyser1, and having fast results when they are needed has helped streamline workflow, with less time dedicated to following up test results in the lab.
"We would be going between other patients and just checking in every 10 minutes to find out if the result is there, but you're waiting potentially up to two hours, it just depends on what's happening up in the lab," said Ms Ellis.
During the COVID pandemic the unit's i-STATTM system was needed in the intensive care unit at the hospital. While it was on loan to ICU, Ms Ellis said the fast bedside blood results were sorely missed by staff.
"It has actually become part of our day to day now, to be able to get those results, really, really quickly to improve our patient care, to reduce waiting times."
In addition to the urgent situations where the i-STATTM products play a crucial role, it has been highly beneficial in regular patient care such as when dialysis cannot be performed on the day as planned, due to damaged blood vessels preventing access. To ensure it is safe to delay dialysis, a blood test is needed but without i-STATTM system this could mean a patient waiting two hours for test results.
Ms Ellis said; "These patients come in three times a week for up to five or six hours, they're already here for so many hours of their week we don't want them waiting around for blood tests, if we can help it."
Five benefits of the Abbott i-STATTM system
- TESTING DELAYS – Maximise resources by assessing renal function in minutes, enabling immediate care for routine and urgent cases.
- RELIABLE ACCURACY – Lab-accurate results enable radiology clinicians to make patient care decisions with confidence.
- SMALL SAMPLE SIZE – Just two or three drops of blood are required, making testing easier on staff and patients.
- EASE OF USE – Simple, intuitive operation of the i-STATTM system with the Creatinine and CHEM8+ cartridges make it ideal for busy imaging practices.
- ON-SCREEN CALCULATIONS – i-STATTM can be set to display a calculation such as eGFR automatically.
The results shown here, and quoted comments are specific to one health care facility and may differ from those achieved by other institutions.
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1 Operator training is provided by APOC to new users.