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Modern healthcare providers use point of care testing (POCT) for a wide range of applications, typically citing convenience and speed as primary advantages. That doesn’t tell the whole story, though. Research shows1 that it also “enables patient counseling, prevents unnecessary treatment escalation, and provides rapid results outside the hospital setting,” which lets healthcare organizations streamline their processes and increase accuracy by “eliminating the need for sample transport, reducing turnaround time (TAT), and avoiding procedure delays.1”
Point of care testing first emerged in the 1980s1, thanks to “extensive research on the application of biosensors for monitoring ionized calcium levels in whole blood1” by Dr. Gerald J. Kost. Not too long after, POCT was “codified with the definition of ‘testing at or near the site of patient care’, 1" a definition that still rings true (despite the expansion of POCT capabilities and methods.
Today, the POCT blood test has a number of distinct applications, including blood analysis testing for disease diagnosis and clinical monitoring. But, how do these systems work—and are they worth the investment? This article will answer some of the most common questions about the effective implementation of POCT blood analysis testing, including the key advantages of a point of care blood analysis system such as epoc® Blood Analysis System and how to use the epoc solution developed by Siemens Healthineers.
Point-of-care (POC) blood gas analysis testing measures the levels of oxygen and carbon dioxide in a patient’s blood sample, as well as its pH. Whether done in a clinical setting or as a POC intervention, blood gas testing is often used for evaluating potential respiratory, lung, or breathing problems—or for understanding the effectiveness of existing treatments for patients with persistent conditions.
Blood analysis testing has several major use cases, and may be ordered for a wide range of reasons. One major reason for blood analysis is blood gas testing, which can be used in evaluating patients for potential lung disease (such as pneumonia or emphysema). In part, blood gas analysis testing measures the levels of oxygen and carbon dioxide in a patient’s blood sample, as well as its pH. Providers may order blood gas analysis in order to help identify or diagnose a number of patient symptoms, including:
In addition to basic blood gas testing, providers may also order other, related blood tests offered by blood analysis systems including checking electrolytes (Sodium, Potassium, Chloride, Ionized Calcium) and metabolites (Blood Urea Nitrogen, Creatinine, Glucose, Lactate). This collection of tests—sometimes referred to as basic chemistries or a basic metabolic panel—provides a snapshot of a patient’s health, including kidney function, blood sugar levels, and levels of key ions involved in fluid balance. The epoc® Blood Analysis System provides the key measurements of blood gases, electrolytes and metabolites on one test card, from only a few drops of blood.
Regardless of the use case or context, the primary objective of epoc blood analysis is the same: to help providers to quickly assess patients, provide timely answers with maximum accuracy and convenience, and determine the appropriate next step(s) or course of care.
Broadly speaking, blood gas testing is one use case for POCT—and venous blood gas testing is one method for POCT for blood analysis (along with arterial blood gas or capillary-based blood testing). The specific test and sample types depend on the specific circumstances, context, and objective.
As the National Institutes of Health (NIH2) notes, while “arterial blood, driving directly from pulmonary circulation, accurately reflects respiratory conditions,” venous blood sampling “is a superior alternative to ABG analysis for patients experiencing metabolic disturbances.2”
Whether using blood sampled from veins, arteries, or capillaries, modern POCT methods provide a high level of convenience, efficiency, and accuracy, with samples being collected and tested with a turnaround time, from sample introduction, of around a minute or less. This means healthcare providers can make more timely and sound recommendations for patient care, ultimately improving outcomes.
The epoc Blood Analysis System—which provides quick, lab-accurate blood gas, electrolyte, and metabolite (BGEM) results—can be used in a wide range of applications and use cases across the care continuum. It can wirelessly and securely connect the entire care team, providing them with timely insights and information they can use to provide patients with the right care at the right time, with streamlined workflows leading to increased efficiency and accuracy, along with reduced costs.
Especially when performed as convenient point of care testing, blood analysis can provide crucial answers for patients throughout the healthcare system, including in areas like:
Emergency departments and transport teams can use the epoc System to quickly assess the seriousness and urgency of a patient’s condition, including determining whether a patient needs to be transferred to the ICU (or elsewhere) for the appropriate care.
The epoc System’s quickness and accuracy are major benefits that can help reduce the time to treatment or diagnosis. This, in turn, alleviates overcrowding and other delays within emergency departments, and helps toward using healthcare resources in an efficient and cost-effective manner.
Within a respiratory care or intensive care environment, patients’ conditions can change drastically over the course of a short time. The ability to use the epoc System for fast, laboratory-accurate results enables providers to easily monitor patients’ oxygenation and physiological perfusion, for example. This application of epoc can lead to more effective ventilator utilization and management, near real-time responses to physiological changes, more efficient resource allocation, and other positive outcomes. Additionally, the epoc System in these settings, as well as in emergency rooms and transport, can help with early recognition of elevated lactate levels that may hasten the detection of time-sensitive illness.
When working with infants, taking too much blood (for sample purposes) can be dangerous—with the potential to exacerbate anemia, for example. Providers in these areas must minimize how much blood they draw in order to reduce the risk of infections or other complications.
By minimizing how much blood is required for analysis, the epoc System provides a safer method than its alternatives, without compromising accuracy or efficiency. Using epoc in a NICU/PICU setting makes it possible for caregivers to respond immediately to key analytical parameters, like fluid loss, ventilation, metabolism, and effects from anticoagulant usage—providing lab-accurate results in under a minute from sample application.
Some patients are at risk of side effects from the common, iodine-based contrast media often used for radiology purposes, including the potential for nephrotoxicity.
When imaging or radiology departments have an epoc System available, they can quickly check creatinine levels so an alternative contrasting agent or method may be used, mitigating that particular risk and improving diagnostic accuracy.
Using an epoc System within the operating room enables clinicians’ ability to rapidly monitor, assess, and manage a patient’s condition throughout a procedure—with many of these decisions having potentially life-altering consequences.
The epoc Blood Analysis System puts quick, laboratory-accurate testing at the fingertips of surgeons, anesthesiologists, perfusionists, and nurses—each of whom plays a vital and valuable role in delivering patient care.
The epoc Blood Analysis System measures 13 distinct analytes relating to patients’ blood gas, electrolyte, and metabolite (BGEM) levels. The epoc System enables this robust testing without requiring multiple epoc test cards. Instead, a single test card can be used to measure any or all of the following parameters:
The epoc System also calculates measurement of 18 additional clinical values, including hemoglobin, anion gap, eGFR. While the methodologies related to analyte measurement may be distinct, one of the top benefits of epoc testing is that multiple test cards are not required. You can learn more about these test parameters and related considerations by viewing the Summary of Analytical Methods and Performance whitepaper.
Key advantages of the epoc Blood Analysis System include reduced turnaround time, increased operational efficiency, accuracy and quality you can count on, and improved IT security.
Especially in critical care settings, being able to administer tests and receive (and interpret) their results quickly can be the difference between a timely, life-saving intervention and losing a patient.
The ability to use a handheld, point-of-care blood analysis testing system helps providers to make the kind of quick, confident decisions their patients are counting on, and to do so in a timely, data-informed manner. Without having to leave the patient’s bedside, providers can easily collect samples and receive actionable results in less than a minute from sample application.
When caregivers are tied to cumbersome workflows, it can greatly impede their ability to deliver timely care. Testing procedures and workflows shouldn’t be complicated or overly burdensome, and with the epoc System, they are streamlined and efficient.
Because samples are collected and tested at the patient’s bedside, physicians don’t wait for important clinical results. Also, they can rest assured in the quality of the patient sample and that the sample being tested reflects the patient's current condition since samples don’t have to be transported to a lab.
In addition to providing lab-accurate blood gas, electrolyte and metabolite (BGEM) test results in less than a minute from sample application, the epoc Blood Analysis System with NXS host is capable of optimizing critical workflows for healthcare providers, including by:
No matter how convenient POC blood testing is, it’s only as useful as it is accurate. And despite the fact that samples are not transported to a dedicated lab environment for testing, the epoc System delivers lab-accurate critical test results patient-side, quickly, enabling fast intervention and treatment.
The epoc System also includes plenty of safeguards for sample traceability. With measures like positive patient ID, automated quality assurance, onboard instructions with visual prompts, color-coded results, and more the epoc workflow can help mitigate errors and improve result accuracy.
Just as vulnerabilities exist whenever blood samples must be transported to and from laboratory and clinical facilities, the same can be said for test results. When using the epoc System for blood testing, there is very little “transport” or associated risk involved.
Samples are taken at the patient’s bedside, and the results are automatically and instantly transmitted via a secure, wireless connection that will often be integrated with data management software (DMS) and related systems like hospital and laboratory information systems (HIS, LIS).
The epoc System doesn’t just handle test results, however. It also integrates with a remote, centralized system for managing devices, operators, inventory, and even quality control. When used properly, this end-to-end system results in more secure data management and the ability for providers to make real-time, appropriate decisions based on lab results.
The epoc System enables collection and testing for 13 different analytes from a single small volume sample and makes the process highly intuitive. There are three main components to the epoc Blood Analysis System: the reader, host computer, and test card.
From the host’s intuitive touchscreen interface to its ability to display and transmit lab-accurate results in less than a minute from sample application, these components work together to greatly streamline and simplify the critical blood analysis. Here’s a step-by-step overview of the basic epoc test procedure that helps optimize testing workflows:
You can learn more about how the epoc System works by:
Several different sample types can be used with the epoc System, including fresh whole blood and/or fresh whole heparinized blood from arterial, venous, or capillary sources. Once the sample has been collected, the epoc machine performs its analysis, simultaneously testing for 13 analytes in virtual real-time:
It depends on the sample type and how it was collected. If using a syringe, a minimum of 92 milliliters will be needed; if using an epoc Care-Fill™ Capillary Tube, a slightly smaller sample (90 milliliters) is needed.
Providers aren’t necessarily required to know how to calibrate the epoc System, since it automatically calibrates prior to blood analysis. With the epoc System, a calibration occurs every time a new test card is inserted, providing ongoing accuracy and consistency.
On average, the epoc System can run up to 50 tests on a single charge, and the system takes around 4 hours to be fully charged—but you can run tests during the charging process.
Yes, system software updates are periodically released, including in coordination with any changes that are made to the latest-manufactured test cards. This helps provide continued accuracy and reliability. Updates are released roughly every 6 months, or twice annually.
Yes, any time the epoc Reader or epoc Host comes into contact with blood (or other contamination), it should be cleaned with either a 10% bleach solution or 70% isopropyl alcohol. No liquid should be applied directly to any internal or external component of the epoc Host or Reader, though—and no electrical contacts should be exposed to liquids.
While it is rare that an epoc machine will need to be reset, should a reset be needed, the epoc POC host can be reset:
The epoc System Manual contains common troubleshooting scenarios, including how to troubleshoot epoc hardware, what to do if the Reader repeatedly fails Electronic QC, and more. When in doubt, Siemens’ epoc technical support can provide further assistance and instruction.
If you’re ready to learn more about Siemens Healthineers epoc blood gas analyzer and the value it can bring to your organization, don’t hesitate to reach out. Our website is also home to several informative resources, including:
You can also reach out to us directly when you’re ready to discuss what epoc implementation might look like for your organization.