Lab Values in the ICU

[Santiago Pinon III]

Has anyone worked in an ICU and uses istat blood analyzers on the regular? Or anything similar to that? Like a portable quick blood analyzer for patients that need frequent lab values?

[MunoRN, RN]

We use them but only for specific patients, mainly ECMO and sometimes CRRT, new MCS devices, etc. In general we use the central lab and our ABG lab.

[Santiago Pinon III]

Thanks, I'm trying to push istat to the ICU where I work. I hate waiting for 30 min to get results on critical patients.

[Wuzzie]

We used them for flight but not in house. They are expensive and require a whole lot of hoop-jumping and red tape to be able to use them so most places would just rather use their central lab.

[LovingLife123]

We use them all the time.

[Santiago Pinon III]

In the ICU? And what kind or brand of the analyzer? How quick are the results?

[meanmaryjean, DNP, RN]

We used iSTAT in our peds ICU. Results are 1-2 minutes.

[MunoRN, RN]

We use iSTAT, I'm not sure how many other approved devices exist, iSTAT is the only POC tester I've heard of that can do a variety of labs. Results take less than a few minutes. If you get your labs results from central lab typically in 30 minutes then that's not too bad, we get some results from central lab in 30 minutes, but typically it's closer to an hour or more. Outside of the designated patients we can use it for, we can use it only if there's a clear benefit in terms of outcomes, the first sodium check after initiating treatment for hyponatremia for instance.

There are some silly hoops to jump through, the College of Pathologists which is involved in accrediting labs, doesn't seem to like that staff nurses are intruding into their territory and have come up with some odd requirements. We all had to submit copies of our high school diplomas (they wouldn't accept a college degree as proof we graduated from high school) to get signed off on iSTATS because the College of Pathologists required this specifically.

Abbott Point of Care | i-STAT System & Piccolo Xpress

[EllaBella1, BSN]

We have an ISTAT for our ICU, but not all of our nurses are checked off on using them, and we really only use them in emergent situations.

[Penelope_Pitstop, BSN, RN]

I've been out of the ICU for a few years, but we used iStat for blood gases only...and maybe lactates if I remember correctly.

[Wuzzie]

There are a bunch of CLIA regulations that must be followed as well. One of them requires frequent calibration that must be done in the lab. And the cartridges are uber expensive with a short shelf-life. The ABG cartridge gave us an H/H as well which was very helpful.

[Julius Seizure]

I believe there is also a reimbursement issue. Can't bill the patient/insurance the same for a POC test as a test sent to the lab. That was a reason given to me for why the hospital preferred that labs be sent downstairs except in the most time-sensitive cases.