RAPID rapid test

Posted

Specializes in school nurse. Has 30 years experience.

Had a positive pool from yesterday. During BinaxNow reflex testing this morning, the strip reacted within the first two minutes. And that line was bold.

Unvaxxed 8th grader, started at the school two days ago. *sigh*

 

On the other hand, I tested a runny-nose kiddo on Monday and got a very, very faint reactive line. Mom took him for PCR testing and it was negative. The same thing happened to me during the school's Summer program.

 

Next time I get a very faint positive I'm going to repeat the test then and there.

k1p1ssk, BSN, RN

Specializes in pediatrics, school nursing. Has 11 years experience. 610 Posts

I'm curious if Public Health had anything to say about the follow up PCR - did they have to repeat the PCR at all before being cleared? Last year, they only relaxed on the positive rapids with 3 subsequent negative PCRs (on days 1, 2, and 3 after the positive), which meant the kid was still in isolation for 3 days, which I think was smart... 

MHDNURSE

Specializes in Pediatrics, Community Health, School Health. Has 26 years experience. 696 Posts

I had one like that a couple weeks ago.  The kid was part of a positive pool so we grabbed all the kids to rapid them and figure out who was +. Kid comes down and is coughing and sniffling and says he woke up like that.  That + line appeared almost immediately, even before the control line.

Jedrnurse, BSN, RN

Specializes in school nurse. Has 30 years experience. 2,610 Posts

1 hour ago, k1p1ssk said:

I'm curious if Public Health had anything to say about the follow up PCR - did they have to repeat the PCR at all before being cleared? Last year, they only relaxed on the positive rapids with 3 subsequent negative PCRs (on days 1, 2, and 3 after the positive), which meant the kid was still in isolation for 3 days, which I think was smart... 

Honestly, I didn't call DPH as I got the PCRs back quickly. (I've not heard of repeating the PCR to disprove the antigen test.) The antigen test results went into the database which then uploads to the state, but... 

JenTheSchoolRN, BSN, RN

Specializes in School nursing. 3,011 Posts

So...for my pools 9.9/10 that positive line pops on my positive student in less then 1 minute. I mean the fluid creeps up and the second line is just there. I had that happen for two positive pools this morning, actually.

Flip side? For the first time ever, positive pool with all negative BinaxNOW tests this morning. Protocol for me here is repeat BinaxNOW on the pool tomorrow and I can follow up with an individual PCR if needed. But as at catching COVID when it is infectious. A PCR could pick up COVID at end I use and look at the research, I'm seeing that BinaxNOW is pretty decent of a positive period and that student might not be infectious anymore.

KKEGS, MSN, RN

Specializes in School Nursing. Has 9 years experience. 723 Posts

That happened with my own kid a few weeks ago! Woke up not feeling well on a Monday. Kept her home and got a BinaxNOW from her school nurse. Tested her Tuesday morning. Negative. Tested her Thursday morning. Faint positive. Did a PCR saliva test Thursday afternoon. Negative. Ugh. 🤔 Kept her home the full 10 days anyway since we treat a positive as a positive here. No one else in our house ever tested positive so I don't even know what to think. We reported it to our Dept of Health as a positive.  

k1p1ssk, BSN, RN

Specializes in pediatrics, school nursing. Has 11 years experience. 610 Posts

I had my first positive on a BinaxNOW last week; A TTS kiddo, asymptomatic; And same thing - BOLD line, as soon as the liquid hit that part of the strip. I couldn't believe it so I did a second one, and sure enough, same result. I haven't seen the faint line on a Binax yet - plenty on strep and flu kits, and even one on a quick mono - and these people always have been positive on reflex testing. I'm taking them at face value from here on out - as someone said before, a positive is a positive, especially if I have good reason to test in the first place.

RuralMOSchoolRN, ADN, RN

Specializes in ER/School/Rural Nursing/Health Department. Has 16 years experience. 46 Posts

On 12/20/2021 at 10:08 AM, k1p1ssk said:

I had my first positive on a BinaxNOW last week; A TTS kiddo, asymptomatic; And same thing - BOLD line, as soon as the liquid hit that part of the strip. I couldn't believe it so I did a second one, and sure enough, same result. I haven't seen the faint line on a Binax yet - plenty on strep and flu kits, and even one on a quick mono - and these people always have been positive on reflex testing. I'm taking them at face value from here on out - as someone said before, a positive is a positive, especially if I have good reason to test in the first place.

I'm in a small rural school district--we have the BinaxNOW tests through a state program.  But you also have strep, flu, and mono tests in your nursing office? Who gives those to you/who do you get orders from?  Do you have blanket permission slips to test the kids at the beginning of the year? I'm just curious since we have had a lot of strep and doing a quick test would be great but seems like a bigger reach for my schools to offer something like that.  Also, is that in the school budget or do you bill parents or how do those tests get paid for.

k1p1ssk, BSN, RN

Specializes in pediatrics, school nursing. Has 11 years experience. 610 Posts

20 hours ago, RuralMOSchoolRN said:

I'm in a small rural school district--we have the BinaxNOW tests through a state program.  But you also have strep, flu, and mono tests in your nursing office? Who gives those to you/who do you get orders from?  Do you have blanket permission slips to test the kids at the beginning of the year? I'm just curious since we have had a lot of strep and doing a quick test would be great but seems like a bigger reach for my schools to offer something like that.  Also, is that in the school budget or do you bill parents or how do those tests get paid for.

Oh I'm sorry, I should have been more clear; While I work FT in a public school (where the Binax RATs are supplied by the state), I also hold a PT weekend job at a private boarding school, which has an MD and NP; We have standing orders for the rapid flu/strep/mono (and COVID) and part of those is to reflex with PCRs/Throat cultures if they are negative but suspicious. All families there must sign consent for treatment without explicit permission prior to the start of the school year. We have a TON of international students, and so calling every time would be a real PITA. 

I do know of some public schools in our state that have clinics as part of the school, and those nurses sometimes have access to rapid tests for other common illnesses, but they are very expensive, and I imagine those schools' supplies are used at the discretion of their providers more-so than the nurses. I think in those situations the students parents are contacted for consent prior to obtaining the test and yes, insurance is billed.