The Essence: The Best of August 2020

By Anne-Margaret Olsson posted 19 days ago

The Artery is your community for finding solutions to your day-to-day clinical chemistry questions. Last month, several answers were found to questions ranging from “Are there formal guidelines on pre-surgical procedure COVID testing?” to “Adopting pooled COVID testing- does reporting overwhelm your staff?”. Read on for our editor’s picks of the best discussions on the Artery in August.

Arterial Blood Samples for Tests
Initiated by @Qing Meng, PhD, MD, DABCC, FAACC

One lab has learned that most of the blood samples they receive are arterial and not venous, leading them to wonder if their tests would be considered lab-developed tests, since most of their chemistry and IA tests were validated using venous blood. In response, others have shared research showing that the difference in results when using venous versus arterial blood is minimal. Another respondent added that both sample types are still blood, and therefore a test performed on arterial blood shouldn’t be considered off-label.

Pre-op COVID Testing?
Initiated by @Charles Beavers, MD

One lab is wondering whether there are formal guidelines yet on pre-surgical procedure COVID testing. Their institution currently requires a negative COVID PCR test within 72 hours of a procedure. Two other institutions do the same for routine appointments, while for emergency surgery, one place runs COVID-19 PCR on admission through a reference lab. Respondents also say that surgical associations are in the process of discussing guidelines, and in the meantime, the Anesthesia Patient Safety Foundation has compiled on their website how different institutions and states are approaching this.

Pooling and LIS/Reporting of Results
Initiated by @Carmen Wiley, PhD, DABCC, FAACC

A lab professional who is thinking of adopting pooled COVID testing is worried that reporting would need to be done manually and could overwhelm reporting staff. In response, one lab that has been pooling since early July outlined their approach to reporting pooled results and says that the process has been manageable so far. Another lab doing pooled testing admits it has been very labor intensive and difficult on staff to both prepare and manually report all pools, and that it has increased their turnaround time for COVID tests, too. They have saved 40% of their reagents by pooling, though, and feel that it is worth the extra effort in order to test as many patients as possible.