Temperature Challenges for i-STAT and epoc POC Blood Gas Devices in Field Settings
This review systematically evaluates temperature-related challenges and solutions for the Abbott i-STAT and Siemens epoc point-of-care blood gas analysers used in prehospital and disaster settings. Most reported solutions are low-cost and portable but demonstrate only partial effectiveness in maintaining manufacturer temperature claims. Evidence suggests reagent cartridges may tolerate brief storage outside specifications with minimal performance loss, but the authors call for better-designed studies and manufacturer collaboration.
The original study
A review of temperature-related challenges and solutions for the Abbott i-STAT and Siemens Healthineers epoc devices.
- Authors
- Füzéry AK, Elian FA, Kost GJ
- Journal
- Clinical biochemistry
- Type
- Review, Journal Article
- PMID
- 36067872
Original abstract
The Abbott i-STAT and Siemens Healthineers epoc are commonly used in the provision of care during emergency medical services calls and other settings. Maintaining these systems within manufacturer's temperature claims in these settings poses challenges across the world. This review summarizes solutions that have been reported in the peer-reviewed literature and proposes additional strategies to further address these challenges. A literature search was performed with Clarivate's Web of Science from inception to August 3, 2022. Search terms included i-STAT, epoc, temperature, cold, hot, heat, freeze, frozen, prehospital, disaster, POCT, point of care, blood gas, helicopter, airplane, and ambulance. One author also reviewed manually every issue of the Journal of Paramedic Practice. The search identified 17 solutions for addressing temperature-related challenges with the i-STAT device, nine solutions for i-STAT cartridges, one solution for the epoc device, and one solution for the epoc test card. The majority of solutions were highly portable and consisted of widely available, inexpensive components. The solutions demonstrated only partial or entirely questionable effectiveness in achieving temperature control. The search also identified five reports on the impact of storage temperatures on cartridges and test cards. The reports suggested that these reagents may be able to withstand storage at temperatures outside of manufacturer's claims with only minimal deterioration in performance. The heterogeneity of solutions and the paucity of evidence on their effectiveness suggest that additional strategies are needed to better understand and further address temperature-related challenges with these systems. A collaborative approach and shared decision making are recommended.