Using Blood in Point of Care Urine Pregnancy Tests?

Altra, BSN, RN · May 17, 2012

Some brands of POC tests can be used with urine or serum, but not all.

It's never been a problem where I've worked -- the patient provides the sample in the cup, so it's easy to do the point of care testing before filling the tubes and sending them to the lab.

Yes - pregnancy tests on all females of childbearing age who are going to get a dose of radiology.

psu_213, BSN, RN · May 17, 2012

I don't know if we can use blood on ours or not...but the POC testing manual at my facility only specifies urine.

Women of childbearing age will get a pregnancy test if indicated (abd pain, discharge, burning on urination--OK, I don't know how indicated it is in the last one, but they will still get one) or if they are getting a CT. We will not do one just because a woman is in her childbearing years (i.e. no pregnancy test on someone with a sprained ankle). Depending on the doc we might not do one some who checks in with a CC of "needs pregnancy test."

Anna Flaxis, BSN, RN · May 17, 2012

Our POC urine preg can also take blood, but I've never tried it. Don't usually have a problem getting pee out of child bearing age females with pelvic complaints.

Guest 360983 · May 18, 2012

Ya'll use tubes? We have patients pee in a cup and then send the whole cup down. Well, we have them pee in two cups; one dirty, one clean for cultures. Funny how labs can be so different.

We do pregnancy test on the patients who obviously need a pregnancy test--if she says she's pregnant, if she has any abdominal complaint, if she's coming in with a headache and it's Dr. $1 Million Workup. The problem we've been running into is that the doctors are starting to order really bizarre CTs on people. I really liked the woman who had a tooth abscess and had been treated and cleared by oral surgery and by face, and the case was sent back to the ER resident. He then decided that was the time for a CT scan. Ok, she probably should have had one to begin with earlier, but still... 14 hours and 2 specialists later, and you want the CT scan now? Of course, the patient didn't have any urine anymore and she was not up to drinking much water, so we had to bolus her just to get her to pee to do the CT.

Part of the problem is that the resident will order the UA/UDS very quickly but won't order a CT scan for another hour. Then we have to hope that the lab will run the pregnancy test as a add on, which is a 50/50 shot on good days. I suppose this is something we should be fixing on both ends--the docs giving us an idea of when they're thinking CT, and us just finding the time to do more pregnancy tests when patients present.

psu_213, BSN, RN · May 18, 2012

if she's coming in with a headache and it's Dr. $1 Million Workup.

Lol. Our doctor who holds this title says that he "doesn't trust" our POC urine pregnancy tests. Therefore, if there is any question in his mind of pregnancy, he orders a blood hCG level. Talk about annoying (and a waste of money!).

Altra, BSN, RN · May 18, 2012

Lol. Our doctor who holds this title says that he "doesn't trust" our POC urine pregnancy tests.

OMG - I work with that physician's twin. Ours doesn't trust lab results either, but seems to trust whatever crystal ball-divining-reading of the oracle method he can use to supplant multiple other testing modalities ...

sauconyrunner · May 18, 2012

They took our POC away there was a huge recall on the cartridges for too many false positives so now we send to the lab. No issue getting urine, but- we have it drilled into our brains to ask for it immediately. I explain that we need the sample so we can proceed with other tests AND medications. Seems to work pretty easily. I also offer to do a quick cath...and that encourages sample collection effectively.

If your problem is "A lot of nurses forget to run one before sending to the lab" then the problem is not that you need to use blood, your nurses can either split the UA and save some for running, or remember to run it. I think any women of child bearing age who comes in for a Pelvic complaint should have a pregnancy test. If they come in for ankle pain and end up with an abdominal CT, well, thats an unexpected outcome (though it seems to happen ALL the time doesn't it!)

VICEDRN, BSN, RN · May 18, 2012

We allow patients to sign waivers in radiology for pregnancy tests. As a woman, I think that's appropriate and respectful. Most of our patients sign the waiver unless they have irregular periods, state they aren't sure if they are pregnant or state they specfically are pregnant.

Our point of care tests specifically say not to use blood but yes, I have seen people do it anyway. Otherwise, we straight cath people if we are desperate for results.

For some CTs, we also use iStat for creatinine.

Edited to add: if your problem is that you ran the UA already, I would have added a u preg or held onto a specimen when I sent the UA (yeah yeah yeah joint comission blah blah unordered specimens blah blah blah)

And my mantra is everyone produces 30 ml/hour. After an hour or two, I KNOW you can give me 3 tiny drops for a u preg. I KNOW it.

psu_213, BSN, RN · May 19, 2012

And my mantra is everyone produces 30 ml/hour. After an hour or two, I KNOW you can give me 3 tiny drops for a u preg. I KNOW it.

I was just talking about this at work yesterday. Had three pt's in a row who, when asked if they can produce a urine sample, said "no, I went just before I left home." OK, fine, maybe they all did. But, you left home, spent 10 minutes getting here, another 12 before you went to triage, another 6 minutes in triage, waited in the room 16 minutes before the doc came in, and, finally, another 5 before I came into the room to tell you we needed a sample. I'm guessing there is enough in there for a UA. Or do people think they need to fill the specimen cup full? Usually when they tell me "oh, I don't think I can go, but I will try," they come back with the cup overflowing and dripping with pee.

Sorry, off the original topic, but an annoyance none the less.