Embedding Point of Care monitoring (ROTEM) in daily practice
|
|
|
- Clare Fisher
- 8 years ago
- Views:
Transcription
1 Embedding Point of Care monitoring (ROTEM) in daily practice Yvonne Henskens Clinical chemist Head of unit General Hematology, Hemostasis and Transfusion Central Diagnostic Laboratory
2 Road to ROTEM 2009
3 Our clinicans were not satisfied Blood products were ordered, based on expert opions and not based on protocols or hemostatic tests NOT CLINICALLY USEFULL NOT SENSITIVE NOT SPECIFIC
4 Goal: BETTER and FASTER laboratory tests for bleeding patients in our hospital.
5 How FAST are our traditional Laboratory Tests??
6 Theoretical Turn Around Time (TAT) Step 1. From indication to order and blood drawing Hemoglobin Platelet count?? APTT, PT, Fibrinogen 2. Transport tot laboratory 2 min 2 min 3. Register order into LIS 5 min 5 min 4. Centrifugation step min 5. Preparation of analysis 5 min 5 min 6. Analysis 3 min 3 min 7. Technical validation of result 16 minutes 26 minutes 3 min 3 min
7 REALITY FIGURES OF TAT (2012) Median (IQR) in minutes STAT SUPER STAT Platelet count 26 (13-63) 13 (9-22) Fibrinogen 61 (48-82) 37 (31-54)
8 Definition of BETTER Laboratory Tests Clinically useful Diagnostic accuracy and precision Easy and correct interpretation of test results
9 Accuracy and precision Henskens/Zwolle/2013
10 Literature on precision of TEG or ROTEM is not very promising! Quality assurance and quality control of thrombelastography and rotational Thromboelastometry: the UK NEQAS for blood coagulation experience. Kitchen DP et al, Seminar Thromb Hemos 2010 Variance between hospitals: 7.1 to 39.9% for TEG (n=18) 7.0 to 83.6% for ROTEM (n=10)
11 IMPLEMENTATION SCHEDULE 2009: VISITING BEST PRACTICES Copenhagen (Per Johanssen, TEG) London (Benny Sörensen, ROTEM) 2010: MAKING CHOICES TEG or ROTEM OR (bed side) or in CENTRAL LAB : VALIDATION and IMPLEMENTATION 2011: START in PATIENTCARE
12 POCT equipment in central lab: WHY? Rule of Health Care Inspectorate (IGZ) in The Netherlands and Policy of our hospital Only use bedside testing when strictly necessary Results in the hospital information system All bedside tests are quality controlled by the central lab Staff has to be (re)trained by central lab Good collaboration and communication between anesthesiology, hematology and central laboratory
13 Distribution of POCT equipment in MUMC+ Central Laboratory Bedside (OR, ER, Ward) Blood gas analyzers (3) Blood gas analyzers (3) Verify Now (1) Coaguchek (3) Platelet Function Analyzer (1) Glucose meters (23) Multiplate (2) Hemocue (2) ROTEM (2) Team of 5 technician s
14 Validation procedure with 2 ROTEMs before starting in patient care (only cardiothoracic surgery)
15 Quality control of ROTEM Variation is between 1 and 8 % Parameters on ROTEM EXTEM Normal control sample EXTEM Abnormal control sample INTEM Normal control sample INTEM Abnormal control sample CT 4,3 5,2 2,3 4,2 Alpha 0,9 2,6 0,8 5,7 A5 4,8 4,1 5,3 8,3 A10 4,8 3,2 4,8 7,4 MCF 3,3 3,1 3,7 7,5
16 Pneumatic tube transport of ROTEM samples 100 MCF Maximum Clot Formation [mm] MCF_intem_tube MCF_intem_walk MCF_extem_tube MCF_extem_walk MCF_fibtem_tube MCF_fibtem_walk
17 ER ICU CENTRAL LAB OR RECOVERY Web-based IT connections Delivery ward
18 Tube transport (2 stations in OR) Henskens/Zwolle/2013
19 Trained technicians (n=20) Henskens/Zwolle/2013
20 OR: viewer function Henskens/Zwolle/2013
21 Live viewing AND data in HIS Henskens/Zwolle/2013
22 Cardio-OR (6 anesthesiologists and 8 perfusionists) Henskens/Zwolle/2013
23 TRAINING PHASE for interpretation Started with cardiothoracic surgery 3 ROTEM specialists for consultation Start with ROTEM use 5X8 Procedure for inclusion-interpretation-treatment Use all tests (ROTEM, platelets, APTT, PT, fibrinogen Evaluate results (repeat, repeat, repeat )
24 Conclusions after 18 months of ROTEM How many patients get a ROTEM analysis? What is de quality of the result after 18 months? Can we skip the traditional fibrinogen and platelet count? How fast is ROTEM? Can it be faster?
25 Increase in ROTEM analyses 15 % 10 % Average 1,5 ROTEM/patient
26
27 Transfusions and ROTEM (first year) Transfusions/ROTEMpatient Period 1 Period 2 Total Before first ROTEM order After first ROTEM order
28 QUALITY CONTROL NOW MCF CT MCF ROTEM 2 (mm) CT ROTEM 2 (Seconden) MCF ROTEM 1 (mm) Henskens/Zwolle/2013 CT ROTEM 1 (seconden) R 2 = 0,9926 R 2 = 0,9759 MCF Extem MCF Intem MCF Fibtem MCF Aptem MCF Heptem MCF CT Extem CT Intem CT Fibtem CT Aptem CT Heptem Lineair (MCF) CT Lineair (CT)
29 Step THEORETICAL Turn around time Hemoglobin Platelet count APTT, PT, Fibrinogen 1. Indication,order,bloodsample??? ROTEM 2. Transport tot laboratory 2 min 2 min 2 min 3. Order in LIS 5 min 5 min Centrifugation steps min Preparation of analysis 5 min 5 min 3 min 80 sec/test TOTAL 10! 6. Analysis 3 min 3 min CT 2 min CFT 5 min MCF 25 min 7. Technical validation of result 3 min 3 min Live viewing STEP 3-7: TOTAL in theory 16 min 26 min min
30 ROTEM-guided transfusion procedures Henskens/Zwolle/2013 Girdauskas E et al. J Thorac Cardiovasc Surg Nov;140(5): e2.
31 ROTEM-guided transfusion procedures Henskens/Zwolle/2013 Gorlinger K et al. Anesthesiology 2011; 115:
32 Amplitude after 5 minutes MCF A10
33 A5 in comparison to conventional tests EXTEM A5 EXTEM A10 EXTEM MCF FIBTEM A5 FIBTEM A10 Trombocyten 0,75 0,74 0, Fibrinogeen ,88 0,88 0,88 FIBTEM MCF
34 Turnaround time (TAT) in PRACTICE Median (IQR) (min) STAT SUPER STAT Platelet count 26 (13-63) 13 (9-22) Fibrinogen 61 (48-82) 37 (31-54) ROTEM A5 17 (16-21)
35 PLTEM EXTEM - FIBTEM EXTEM A5 Henskens/Zwolle/2013 EXTEM A10 EXTEM MCF PLTEM A5 PLTEM A10 Platelets 0,75 0,74 0,70 0,88 0,87 0,81 PLTEM MCF
36 Quality plans for 2013 ECAT (Piet Meijer) External Quality Control PROGRAMME 17 participating laboratories (6 OR and 11Lab) 18 ROTEMs 11 TEGs
37 ONE tube of blood gives you information on 1. Clotting factors and clot formation speed (CT, CFT) 2. Fibrinogen (FIBTEM) 3. Platelet count (PLTEM) 4. Fibrinolysis (APTEM) 5. Heparin (HEPTEM) Hematocrit has to be measured on a bedside POCTmeter (blood gas analyzer)
38 Complete ROTEM based treatment of all bleedings
39 Rick Wetzels Rene van Oerle Paul Verhezen Yvonne Henskens BTCIE PATIENT Erik Beckers Marcus Lancé Esther Bouman Geert Jan Kuiper Patrick Weerwindt Liesbeth Scheepers
Point-of-care testing Thrombelastography and platelet transfusion
Point-of-care testing Thrombelastography and platelet transfusion Gisela Scharbert Department of Anesthesiology, Intensive Care and Pain Management Vienna Medical University, Austria Trauma-induced coagulopathy
Thromboelastometry in neonates and infants undergoing cardiac surgery
SIGNA VITAE 20; 8(2): 7-4 ORIGINAL Thromboelastometry in neonates and infants undergoing cardiac surgery GORAZD KALAN ENVER MELKIC MOJCA GROSELJ-GRENC MOJCA GROSELJ-GRENC ( ) GORAZD KALAN Department of
ORIGINAL PAPERS. Effects of Rivaroxaban Therapy on ROTEM Coagulation Parameters in Patients with Venous Thromboembolism**
ORIGINAL PAPERS Adv Clin Exp Med 2015, 24, 6, 995 1000 DOI: 10.17219/acem/42147 Copyright by Wroclaw Medical University ISSN 1899 5276 Krzysztof Chojnowski*, A, C F, Tomasz Górski*, A F, Marta Robak B,
Hemostasis analyzer system
Hemostasis analyzer system Providing fast, actionable results to help you reduce risks, complications and costs Get the whole picture with TEG Hemostasis analyzer system For more than forty years, hospitals
Hemostas under graviditet och förlossning. Ove Karlsson Sahlgrenska Universitetssjukhuset
Hemostas under graviditet och förlossning Ove Karlsson Sahlgrenska Universitetssjukhuset Handledare Margareta Hellgren, professor Obstetriska kliniken, Område 1 Sahlgrenska Universitetssjukhuset Anders
4/24/2015. Urgent, STAT, Super STAT, ASAP! Achieving timely lab testing for the Emergency Department. Learning Objectives.
Urgent, STAT, Super STAT, ASAP! Achieving timely lab testing for the Emergency Department Nichole Korpi-Steiner, PhD, DABCC, FACB University of North Carolina Chapel Hill, NC Learning Objectives Describe
Thromboelastometry- The New Coagulation Measurement. Andrew Bernard, MD Associate Professor of Surgery Trauma Center Medical Director UK Healthcare
Thromboelastometry- The New Coagulation Measurement Andrew Bernard, MD Associate Professor of Surgery Trauma Center Medical Director UK Healthcare Objectives 1. Understand how thromboelastometry works
Going Beyond Laboratory Automation: Do Less Accomplish More. Swedish Covenant Hospital
Going Beyond Laboratory Automation: Do Less Accomplish More Susan Dawson, MBA, MT(ASCP) Swedish Covenant Hospital Chicago, IL Swedish Covenant Hospital Open Heart Oncology Birthing Unit Community Outreach
Phlebotomy Handbook Blood Collection Essentials Seventh Edition
Phlebotomy Handbook Blood Collection Essentials Seventh Edition Diana Garza Kathleen Becan-McBride Chapter Four The Cardiovascular System Introduction Circulatory system is a transport system. Contributes
Thrombin Formation for Children on Lovenox. Steven Ignell, BA
Thrombin Formation for Children on Lovenox Steven Ignell, BA Definitions Anticoagulation Historically this refers to inhibiting thrombin formation Measured by PTT, INR, anti-xa Hypo and hypercoagulation
ELSO GUIDELINES FOR ECMO CENTERS
ELSO GUIDELINES FOR ECMO CENTERS PURPOSE These guidelines developed by the Extracorporeal Life Support Organization, outline the ideal institutional requirements needed for effective use of extracorporeal
New Oral Anticoagulants
Laboratory Monitoring of New Oral Anticoagulants.....What you need to know Rita Selby MD Medical Director, Coagulation Laboratories Uniersity Health Network & Sunnybrook HSC Uniersity of Toronto The 15
ADMINISTRATIVE MANUAL Policy and Procedure
ADMINISTRATIVE MANUAL Policy and Procedure TITLE: Point of Care Testing NUMBER: CH 30-111 (Laboratory Diagnostic Bedside Testing) Effective Date: January 2014 Page 1 of 6 Applies To: Holders of Administrative
Monitoring Thrombin Generation: The Holy Grail of Laboratory Hemostatic Assessment.
Monitoring Thrombin Generation: The Holy Grail of Laboratory Hemostatic Assessment. Marcus E. Carr, Jr., MD, PhD Professor of Medicine, Pathology, and BioMedical Engineering Director of the Central Virginia
UNIVERSITY OF CONNECTICUT HEALTH CENTER CORRECTIONAL MANAGED HEALTH CARE POLICY AND PROCEDURES FOR USE WITHIN THE CONNECTICUT DEPARTMENT OF CORRECTION
UNIVERSITY OF CONNECTICUT HEALTH CENTER CORRECTIONAL MANAGED HEALTH CARE POLICY AND PROCEDURES FOR USE WITHIN THE CONNECTICUT DEPARTMENT OF CORRECTION NUMBER: P 1.01 Page 1 of 1 PATIENT SAFETY SYSTEM/PSS:
New anticoagulants: Monitoring or not Monitoring? Not Monitoring
The 2 nd World Congress on CONTROVERSIES IN HEMATOLOGY (COHEM) Barcelona, Spain September 6 8, 2012 New anticoagulants: Monitoring or not Monitoring? Not Monitoring Anna Falanga, MD Immunohematology and
What is a Critical Test Result in the Medical Field?
LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER SHREVEPORT REPORTING CRITICAL TESTS RESULTS Purpose: To provide a protocol for notification of critical patient test results. Each department is responsible
Accu-Chek Inform II system. Professional glucose testing for the wireless age
Accu-Chek Inform II system Professional glucose testing for the wireless age The Accu-Chek Inform II system Real time control The Accu-Chek Inform II System overview Quality Advanced chemistry with multiple
ELSO GUIDELINES FOR TRAINING AND CONTINUING EDUCATION OF ECMO SPECIALISTS
ELSO GUIDELINES FOR TRAINING AND CONTINUING EDUCATION OF ECMO SPECIALISTS PURPOSE The "" is a document developed by the Extracorporeal Life Support Organization (ELSO) as a reference for current and future
laboratorymedicine> august 2001> number 8> volume 32
interpretation [management/administration and training generalist] A Four-Part Approach to Competency Assessment Jennifer Schiffgens, MBA, MT(ASCP), 1 and Valerie Bush, PhD, MT(ASCP) 2 From 1 Clinical
Worldwide Markets and Emerging Technologies for Point-of-Care Testing, 2013-2019. February 2015
Worldwide Markets and Emerging Technologies for Point-of-Care Testing, 2013-2019 February 2015 INTELAB CORPORATION MARKET AND TECHNOLOGY REPORTS Report 530 Copyright 2015 Worldwide Markets and Emerging
Implementation of a high volume, complex clinical pathway for cardiothoracic surgery patients in the intensive care unit.
Implementation of a high volume, complex clinical pathway for cardiothoracic surgery patients in the intensive care unit. Marion van der Kolk Surgeon/Intensivist UMC St Radboud, Nijmegen The Netherlands
Blood Management Today Incorporating TEG
Blood Management Today Incorporating TEG AMSECT NABM meeting Mike Miller Manager Clinical Manager Hemostasis Training Haemonitics Rx Only 2011 Haemonetics Corporation. Haemonetics, TEG, RapidTEG and Thrombelastograph
Guideline Statement for the Treatment of Disseminated Intravascular Coagulation
Guideline Statement for the Treatment of Disseminated Intravascular Coagulation Introduction Though a rare occurrence in the perioperative setting, disseminated intravascular coagulation (DIC) is a syndrome
Practice Guidelines for Perioperative Blood Management
Practice Guidelines for Perioperative Blood Management An Updated Report by the American Society of Anesthesiologists Task Force on Perioperative Blood Management* P RACTICE guidelines are systematically
I know my value. CoaguChek XS Plus system Smart INR monitoring at your practice. 1 of 6
I know my value CoaguChek XS Plus system Smart INR monitoring at your practice 1 of 6 CoaguChek XS Plus system A better choice for your patients and your practice There has been an extraordinary increase
Specific Standards of Accreditation for Residency Programs in Pediatric Hematology/Oncology
Specific Standards of Accreditation for Residency Programs in Pediatric Hematology/Oncology INTRODUCTION 2009 A university wishing to have an accredited program in Pediatric Hematology/Oncology must also
Collection Guidelines for Routine & Special Coagulation Testing
Revised May 2010 Collection Guidelines for Routine & Special Coagulation Testing Best samples come from peripheral stick with evacuated tube system 19 to 22 gauge needle (smaller or bigger could cause
»medical programs and services. transfusion medicine fellowship program
»medical programs and services transfusion medicine fellowship program new york blood center transfusion medicine fellowship program» Experience at one of the largest nonprofit, community-based blood centers
Abbott Diagnostics. Durable Growth Business
Abbott Diagnostics Durable Growth Business Forward-Looking Statement Some statements in this presentation may be forward-looking statements for purposes of the Private Securities Litigation Reform Act
TPA, STROKE, & TELEMEDICINE. Improving utilization and improving outcomes in a constantly evolving field
TPA, STROKE, & TELEMEDICINE Improving utilization and improving outcomes in a constantly evolving field OVERVIEW tpa inclusion and exclusion evolution Challenges to tpa administration Target:Stroke Telemedicine
How To Improve Poc
Synthèse et conclusions Michel Vaubourdolle Pôle de Biologie Médicale et Pathologie Hôpitaux Universitaires de l Est parisien AP-HP 5 ème Symposium International «Biologie d urgence et gaz du sang» Deauville
Lean Strategies Used to Optimize Automation. Why Lean Six Sigma? Laboratory Goals. Decreased TAT. Accurate Results. LEAN Goals.
Lean Strategies Used to Optimize Automation Linda Stubbs, ASQ CSSBB Senior Workflow Specialist Why LEAN Six Sigma? Why Lean Six Sigma? Laboratory Goals Decreased TAT Accurate Results LEAN Goals Increase
Yvette Marie Miller, M.D. Executive Medical Officer American Red Cross October 20, 2012 45 th Annual Great Lakes Cancer Nursing Conference Troy, MI
Yvette Marie Miller, M.D. Executive Medical Officer American Red Cross October 20, 2012 45 th Annual Great Lakes Cancer Nursing Conference Troy, MI Overview of Hematology, http://www.nu.edu.sa/userfiles/mhmorsy/h
Joint Theater Trauma System Clinical Practice Guideline
Page 1 of 32 Joint Theater Trauma System Clinical Practice Guideline DAMAGE CONTROL RESUSCITATION AT LEVEL IIb/III TREATMENT FACILITIES Original Release/Approval 18 Dec 2004 Note: This CPG requires an
cobas connection modules (CCM) Sample flow solutions for high-throughput laboratories
cobas connection modules (CCM) Sample flow solutions for high-throughput laboratories Expert workflow management The fast track to sample flow efficiency Professional management of laboratory processes
BLOOD BANK SPECIMEN COLLECTION PROCEDURE
BLOOD BANK SPECIMEN COLLECTION PROCEDURE INTRODUCTION Scientific and technical advances in blood group serology have made the transfusion of blood a relatively safe procedure, but serious adverse effects
Samsung POINT OF CARE Systems - Cardiac/Acute Care Biomarkers LABGEO IB Clinical Chemistry Analytes LABGEO PT
Samsung POINT OF CARE Systems - Cardiac/Acute Care Biomarkers LABGEO IB Clinical Chemistry Analytes LABGEO PT Alexander Belenky, PhD Director -Product Development Samsung - Nexus-Dx Edward Brennan, PhD
Consultative Coagulation How to Effectively Answer Common Questions About Hemostasis Testing Session #5020
Consultative Coagulation How to Effectively Answer Common Questions About Hemostasis Testing Session #5020 Dorothy M. (Adcock) Funk, M.D. Colorado Coagulation Karen A. Moser, M.D. Saint Louis University
cobas 8100 automated workflow series 3-D intelligence in lab automation
cobas 8100 automated workflow series 3-D intelligence in lab automation Personalized Lab Automation Maximizing Testing Efficiency and Medical Value At Roche, laboratory automated solutions deliver the
cobas connection modules (CCM) Sample flow solutions for high-throughput laboratories
cobas connection modules (CCM) Sample flow solutions for high-throughput laboratories Expert workflow management The fast track to sample flow efficiency Professional management of laboratory processes
Point-of-care (POC) versus central laboratory instrumentation for monitoring oral anticoagulation
Point-of-care (POC) versus central laboratory instrumentation for monitoring oral anticoagulation David M Dorfman a, Ellen M Goonan a, M Kay Boutilier a, Petr Jarolim a, Milenko Tanasijevic a and Samuel
LABORATORY DIAGNOSIS OF BLEEDING DISORDERS
LABORATORY DIAGNOSIS OF BLEEDING DISORDERS Secondary Hemostasis CIRCULATORY SYSTEM Low volume, high pressure system Efficient for nutrient delivery to tissues Prone to leakage 2º 2 to endothelial surface
- Lessons from SHOT Haemorrhage cases
- Lessons from SHOT Haemorrhage cases Tony Davies Patient Blood Management Practitioner SHOT / NHSBT Patient Blood Management Team SHOT Annual Symposium 2013 For action by Trusts by April 2011 Decision
510(k) SUBSTANTIAL EQUIVALENCE DETERMINATION DECISION SUMMARY DEVICE AND INSTRUMENT TEMPLATE
510(k) SUBSTANTIAL EQUIVALENCE DETERMINATION DECISION SUMMARY DEVICE AND INSTRUMENT TEMPLATE A. 510(k) Number: K041502 B. Purpose for Submission: To change the name of a previously cleared analyzer, and
Damage Control in Abdominal Trauma
Damage Control in Abdominal Trauma Steven Stylianos, MD Surgeon-in-Chief, Morgan Stanley Children s Hospital Rudolph Schullinger Professor of Surgery, Columbia University College of Physicians & Surgeons
»medical programs and services. transfusion medicine fellowship program
»medical programs and services transfusion medicine fellowship program new york blood center transfusion medicine fellowship program» Experience at one of the largest nonprofit, community-based blood centers
If your doctor has ordered laboratory tests, it s natural
A Patient s Guide to Clinical oratory Testing at Kingman Regional Medical Center If your doctor has ordered laboratory tests, it s natural to have questions about why and how the tests are performed. This
DIAGNOSTIC TEST APPRAISAL FORM
DIAGNOSTIC TEST APPRAISAL FORM SCREENING AND TEST EVALUATION PROGRAM (http://www.health.usyd.edu.au/step/) SCHOOL OF PUBLIC HEALTH, UNIVERSITY OF SYDNEY COPYRIGHT This appraisal form may be freely used
CASE STUDY. NHS Board. Contact. Email. Title. Category. Background/ context. NHS Tayside
NHS Board Contact Email NHS Tayside Dr Bill Bartlett (Consultant Clinical Scientist), Tejinder Chima (Clinical Services Manager) bill.bartlett@nhs.net, tchima@nhs.net Title Category Background/ context
A Collaborative Effort to Improve Emergency Stroke Care: Mobile Stroke Unit
A Collaborative Effort to Improve Emergency Stroke Care: Mobile Stroke Unit What can we do to cut down the time it takes to give a clot dissolving drug (tpa)? MOBILE STROKE UNIT! Mobile Stroke Unit Mobile
Hepatocellular Carcinoma (HCC)
Abhishek Vadalia Introduction Chemoembolization is being used with increasing frequency in the treatment of solid hepatic tumors such as Hepatocellular Carinoma (HCC) & rare Cholangiocellular Carcinoma
CAP Point of Care Checklist Frequently Asked Questions Roger D. Klein, MD Sheldon Campbell, MD, PhD Peter J. Howanitz, MD
CAP Point of Care Checklist Frequently Asked Questions Roger D. Klein, MD Sheldon Campbell, MD, PhD Peter J. Howanitz, MD TABLE OF CONTENTS Introduction Applicability General Topics Proficiency Testing
MANAGING BLEEDING IN THE
MANAGING BLEEDING IN THE SETTING OF NEW ANTICOAGULANTS: HOW DO OLD METHODS MEASURE UP? Michelle Zeller MD Clinical Hematology Fellow November 5th, 2011 A FRIDAY NIGHT ON-CALL WITH DR. B. LUD Very keen
Reversal of Antiplatelet and Anticoagulant Therapy: What You Need To Know. Ronald Walsh, MD Chief Medical Officer Community Blood Services
Reversal of Antiplatelet and Anticoagulant Therapy: What You Need To Know Ronald Walsh, MD Chief Medical Officer Community Blood Services HEMOSTATIC PROCESS Initiation and formation of the platelet plug
Expert workflow management cobas p 312 pre-analytical system The new dimension of laboratory automation
Expert workflow management cobas p 312 pre-analytical system The new dimension of laboratory automation Expert workflow management Concept Professional management of laboratory processes in terms of workflow
University Hospital Ulm Ulm, Germany. Prof. Dr. Dr. Dr. h.c. Max G. Bachem, Director Kerstin Stöhrer, Technical Supervisor
University Hospital Ulm Ulm, Germany Prof. Dr. Dr. Dr. h.c. Max G. Bachem, Director Kerstin Stöhrer, Technical Supervisor The University Hospital Ulm was founded in 1982. In 30 years it has built an enviable
CentraLink Data Management System
www.siemens.com/diagnostics CentraLink Data Management System Delivering quality lab results faster for better patient care Answers for life. CentraLink Data Management System Delivering quality lab results
Christine M. Cunningham Associate Professor New York Chiropractic College 2360 Route 89 Seneca Falls, New York 13148 315-568-3122 ccunning@nycc.
Christine M. Cunningham Associate Professor New York Chiropractic College 2360 Route 89 Seneca Falls, New York 13148 315-568-3122 ccunning@nycc.edu EDUCATION Master of Science in Health Sciences Education,
Admission to the Second Degree BSCLS Program. Prerequisite Course Requirements for Second Degree BSCLS
Admission to the Second Degree BSCLS Program This is a 12 month online, second degree tract in clinical laboratory science for students who have completed a four-year science degree from an accredited
Patient Safety Applications for Bar Code and RFID Technology APPLICATION WHITE PAPER
Patient Safety Applications for Bar Code and RFID Technology APPLICATION WHITE PAPER Copyrights 2006 ZIH Corp. All product names and numbers are Zebra trademarks, and Zebra and the Zebra head graphic are
Contents. Abstract... i. Committee Membership... iii. Foreword... vii. 1 Scope... 1. 2 Introduction... 1. 3 Standard Precautions...
Vol. 28 No. 20 Replaces H47-A Vol. 16 No. 3 One-Stage Prothrombin Time (PT) Test and Activated Partial Thromboplastin Time (APTT) Test; Approved Guideline Second Edition This document provides guidelines
Quality Requirements of a Point of Care Testing Service
Quality Requirements of a Point of Care Testing Service Adil I. Khan MSc, PhD Assistant Professor of Pathology Director of Point of Care Testing & Clinical Chemistry Laboratory, Temple University Episcopal
Introduction to Information and Computer Science: Information Systems
Introduction to Information and Computer Science: Information Systems Lecture 1 Audio Transcript Slide 1 Welcome to Introduction to Information and Computer Science: Information Systems. The component,
USE AND INTERPRETATION OF LABORATORY COAGULATION TESTS IN PATIENTS WHO ARE RECEIVING A NEW ORAL ANTICOAGULANT (DABIGATRAN, RIVAROXABAN, APIXABAN)
USE AND INTERPRETATION OF LABORATORY COAGULATION TESTS IN PATIENTS WHO ARE RECEIVING A NEW ORAL ANTICOAGULANT (DABIGATRAN, RIVAROXABAN, APIXABAN) TARGET AUDIENCE: All Canadian health care professionals:
Središnja medicinska knjižnica
Središnja medicinska knjižnica Petričević M., Biočina B., Miličić D., Konosić S., Ivančan V., Milošević M., Burcar I., Gašparović H. (2013) Bleeding risk assessment using multiple electrode aggregometry
Advanced Phlebotomy: An on-line Course for Working Phlebotomists. MORE QUESTIONS? Send questions to phlebotomy@losrios.edu
Advanced Phlebotomy: An on-line Course for Working Phlebotomists MORE QUESTIONS? Send questions to phlebotomy@losrios.edu This course is designed for whom? This course is specifically designed for experienced
Chapter 11: Special Collections and Point-of-Care Testing
Objectives Chapter 11: Special Collections and Point-of-Care Testing 1. Define the key terms and abbreviations at the beginning of this chapter. 2. Explain the principle behind each special collection
BLOOD COLLECTION. How much blood is donated each year and how much is used?
BLOOD COLLECTION How much blood is donated each year and how much is used? Each unit of blood consists of a volume of 450-500 milliliters or about one pint. Because of the constant demand for blood, about
KEY CHAPTER 14: BLOOD OBJECTIVES. 1. Describe blood according to its tissue type and major functions.
KEY CHAPTER 14: BLOOD OBJECTIVES 1. Describe blood according to its tissue type and major functions. TISSUE TYPE? MAJOR FUNCTIONS connective Transport Maintenance of body temperature 2. Define the term
Critical Bleeding Reversal Protocol
Critical Bleeding Reversal Protocol Coagulopathy, either drug related or multifactorial, is a major contributing factor to bleeding related mortality in a variety of clinical settings. Standard therapy
Economic impact of ROTEM -guided Bleeding Control and Patient Blood Management (PBM) Targeted therapy stops the bleeding.
Economic impact of ROTEM -guided Bleeding Control and Patient Blood Management (PBM) Targeted therapy stops the bleeding. Bleeding significantly increases health care costs Bleeding complications and transfusions
Wrong Blood In Tube The Tip of the Iceberg
Wrong Blood In Tube The Tip of the Iceberg Dr Paula Bolton-Maggs SHOT Medical Director 14 th IHS Montréal SHOT Mission Statement (Serious Hazards of Transfusion) To improve patient safety in blood transfusion
Lupus anticoagulant Pocket card
Lupus anticoagulant Pocket card Issue number 5 2012 Antiphospholipid Syndrome 1 The antiphospholipid syndrome (APS) is diagnosed in patients with recurrent thromboembolic events and /or pregnancy loss
The Blood Budget: how can we reduce costs and influence best practice? Sue Redfearn Blood Transfusion Manager Poole Hospital NHS Foundation Trust
The Blood Budget: how can we reduce costs and influence best practice? Sue Redfearn Blood Transfusion Manager Poole Hospital NHS Foundation Trust Poole Hospital vital statistics 680 beds 2011 (reduced
An important first step in identifying those at risk for Cardiovascular disease The Accutrend Plus system: from the makers of the ACCU-CHEK and
An important first step in identifying those at risk for Cardiovascular disease The Accutrend Plus system: from the makers of the ACCU-CHEK and CoaguChek systems Cardiovascular disease: the #1 killer in
PERIPHERAL STEM CELL TRANSPLANT INTRODUCTION
PERIPHERAL STEM CELL TRANSPLANT INTRODUCTION This booklet was designed to help you and the important people in your life understand the treatment of high dose chemotherapy with stem cell support: a procedure
Medical Laboratory Technology Program. Student Learning Outcomes & Course Descriptions with Learning Objectives
Medical Laboratory Technology Program Student Learning Outcomes & Course Descriptions with Learning Objectives Medical Laboratory Technology Student Learning Outcomes All Colorado Mesa University associate
ILLINOIS DEPARTMENT OF CENTRAL MANAGEMENT SERVICES CLASS SPECIFICATION CLINICAL LABORATORY TECHNICIAN SERIES
ILLINOIS DEPARTMENT OF CENTRAL MANAGEMENT SERVICES CLASS SPECIFICATION CLINICAL LABORATORY TECHNICIAN SERIES CLASS TITLE POSITION CODE CLINICAL LABORATORY TECHNICIAN I 08215 CLINICAL LABORATORY TECHNICIAN
Preoperative thrombin generation is predictive for the risk of blood loss after cardiac surgery: a research article
Bosch et al. Journal of Cardiothoracic Surgery 2013, 8:154 RESEARCH ARTICLE Open Access Preoperative thrombin generation is predictive for the risk of blood loss after cardiac surgery: a research article
Level Tow. Level Three
Level One Code No Title Unit Eng 0012 English Language 2)2+1( Chm 0010 General Chemistry 2)2+1( Zoo 0010 General Biology 2)2+1( Com 0012 Introduction to Computer 2)2+1( Ter 0011 Medical Terminology 1)1+1(
Children's Medical Services (CMS) Regional Perinatal Intensive Care Center (RPICC) Neonatal Extracorporeal Life Support (ECLS) Centers Questionnaire
Children's Medical Services (CMS) Regional Perinatal Intensive Care Center (RPICC) Neonatal Extracorporeal Life Support (ECLS) Centers Questionnaire Date: RPICC Facility: CMS use only Include the following
Point of Care HIV Viral Load Testing:
Point of Care HIV Viral Load Testing: Lesley Scott, Natasha Gous, Shuqi Chen *, Wendy Stevens Department of Molecular Medicine and Haematology University of the Witwatersrand, National Health Laboratory
FDA Public Hearing on Clinical Accuracy Requirements for Point of Care Blood Glucose Meters (BGMs)
FDA Public Hearing on Clinical Accuracy Requirements for Point of Care Blood Glucose Meters (BGMs) Barriers to Overcoming Interferences and Limitations Alan T. Cariski, MD, JD, and Mike Flis, AdvaMed BGM
How to Interpret and Pursue an Abnormal Prothrombin Time, Activated Partial Thromboplastin Time, and Bleeding Time in Adults
CONCISE REVIEW FOR CLINICIANS PROLONGED PT AND APTT How to Interpret and Pursue an Abnormal Prothrombin Time, Activated Partial Thromboplastin Time, and Bleeding Time in Adults ARIF H. KAMAL, MD; AYALEW
Central Line Blood Draw
Central Line Blood Draw Welcome to the Central Line dressing blood draw refresher. Please use the navigation below to advance to the next page. The Central Line blood draw module is also available as a
FRANCES P. VELA-CANTOS, APN-c
FRANCES P. VELA-CANTOS, APN-c EXPERIENCE 6/00 - present Acute Care Nurse Practitioner Clinical Research Coordinator Heart and Vascular Institute of New Jersey Division of Cardiothoracic Surgery Englewood
Aktuelle Literatur aus der Notfallmedizin
05.02.2014 Aktuelle Literatur aus der Notfallmedizin prä- und innerklinisch Aktuelle Publikationen aus 2012 / 2013 PubMed hits zu emergency medicine 12,599 Abstract OBJECTIVES: Current American Heart
Bleeding disorders or haemorrhagic diatheses are a group of disorders characterised by defective haemostasis with abnormal bleeding.
Bleeding disorders or haemorrhagic diatheses are a group of disorders characterised by defective haemostasis with abnormal bleeding. Bleeding may be spontaneous in the form of small haemorrhages into the
And Now, Presenting...
Presentation and Handling of Clinical Laboratory Data From Test Tube to Table Randall K. Carlson, Wilmington, DE and Nate Freimark, Lakewood, NJ Omnicare Clinical Research. Inc. INTRODUCTION In human clinical
Session Number 405 CERTIFICATION REVIEW: HEMATOLOGY AND IMMUNOLOGY
Session Number 405 CERTIFICATION REVIEW: HEMATOLOGY AND IMMUNOLOGY Eleanor Fitzpatrick, RN, MSN, CCRN Thomas Jefferson University Hospital Philadelphia, PA Content Description This session will provide
Impact of new (direct) oral anticoagulants in patient blood management
Impact of new (direct) oral anticoagulants in patient blood management Yulia Lin, MD, FRCPC, CTBS Transfusion Medicine & Hematology, Sunnybrook Health Sciences Centre Dept of Laboratory Medicine & Pathobiology,
Sooner, Safer, Smarter: Transforming Surgical Care in Saskatchewan. Taming of the Queue Ottawa March 21, 2013
Sooner, Safer, Smarter: Transforming Surgical Care in Saskatchewan Taming of the Queue Ottawa March 21, 2013 About the Saskatchewan Surgical Initiative Four-year timeframe: April 1, 2010 to March 31, 2014
75515-7 Lupus anticoagulant aptt & drvvt screening panel W Reflex
75515-7 file:///c:/users/cholck/appdata/local/temp/relma_2_49_user_75515-... Page 1 of 1 75515-7 Lupus anticoagulant aptt & drvvt screening panel W Reflex PANEL HIERARCHY LOINC# LOINC Name R/O/C CardinalityEx.
Screening for hemoglobin disorders: Tosoh G7 thalassemia mode
Screening for hemoglobin disorders: Tosoh G7 thalassemia mode Henri Brinkman, Frans Verheul General Clinical Laboratory (AKL) Ysselland Hospital Capelle aan den Yssel The Netherlands Stockholm, October
Session 3 Topics. Argatroban. Argatroban. Drug Use and Adverse Effects. Laboratory Monitoring of Anticoagulant Therapy
~~Marshfield Labs Presents~~ Laboratory Monitoring of Anticoagulant Therapy Session 3 of 4 Michael J. Sanfelippo, M.S. Technical Director, Coagulation Services Session 3 Topics Direct Thrombin Inhibitors:
DVT/PE Management with Rivaroxaban (Xarelto)
DVT/PE Management with Rivaroxaban (Xarelto) Rivaroxaban is FDA approved for the acute treatment of DVT and PE and reduction in risk of recurrence of DVT and PE. FDA approved indications: Non valvular
LOINC Mapping Manual
LOINC Mapping Manual A Guide to assist in the LOINCing of electronic lab results in Nightingale on Demand LOINC Mapping Manual Version 1.0 1 Contents 1.0 Introduction... 3 1.1 LOINC Mapping... 3 1.2 Before
Stop the Bleeding: Management of Drug-induced Coagulopathy. Stacy A. Voils, PharmD, BCPS Critical Care Specialist, Neurosurgery
Stop the Bleeding: Management of Drug-induced Coagulopathy Stacy A. Voils, PharmD, BCPS Critical Care Specialist, Neurosurgery Objectives Discuss contemporary management of warfarin reversal in patients
Symmetry in Diagnostics HPLC ANALYZER. Gold Standard Accuracy by Ion-Exchange HbA1c. TOSOH BIOSCIENCE www.tosohbioscience.us
Symmetry in Diagnostics HPLC ANALYZER Gold Standard Accuracy by Ion-Exchange HbA1c TOSOH BIOSCIENCE www.tosohbioscience.us HPLC ANALYZER HbA1c analysis in 1.6 minutes Direct determination of stable HbA1c