Tuesday, 6 March 2012

Arterial Blood Gas turnaround times

Clinical Lean

Blood gas analysis revolutionised ICU, respiratory and sepsis management. The thing about ABG (arterial blood gas) result is that unless we act upon it quickly, it becomes a total waste of time.

The current turnaround time for blood gas analysis is thought to be 10 minutes; when a point of care testing hand held blood gas analyser is used the turn around time can be reduced to 30 seconds.

The so called total cycle time for blood gas analysis can be reduced from 20 minutes to about 3 minutes when a hand held analyser can be used.

A colleague and friend of mine asked if I would rather have an accurate ABG result in 10 minutes or an inaccurate result in 30 seconds.He went on to state that the hand held blood sugar machines are not used to make a diagnosis of diabetis because they are inaccurate. This line of argument is of course very important. If an inaccurate result is going to harm the patient, a faster inaccurate result will harm the patient very quickly - not good. On the question of POCT (point of care testing) blood sugar, it is very common to use such machines to recognise and treat hypos and hypers though I accept that they are not used for a primary diagnosis of DM. Could the POCT ABG machines used to commence a line of action which could be validated later by a 'proper' machine?

Of course there are pros and cons to this and consequently safety, quality and training issues. The point though is to overcome the reasons why POCT blood gas analysers cannot be used and enable their use safely. After all we moved blood sugar to point of care and now even to patient's homes - at that time arguments about similar issues would have raged. There is no reason why Blood Gas Analysis should not be done at the point of care on a routine basis.It fits in with the broader need to breakdown monuments.

It is a simple and great example of clinical lean in healthcare.

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