Art: 714372-00L Rev. Date: 30-Jul-12 10-3
i-STAT cTnI and CK-MB cartridges require the use of either:
1. heparinized whole blood or plasma samples collected in syringes or
evacuated tubes containing lithium or sodium heparin, or
2. non-heparinized whole blood samples tested within one minute of
drawing from a patient into a plastic syringe or plastic evacuated tube
containing no additives.
The use of whole blood or plasma samples containing other
anticoagulants such as EDTA, oxalate, and citrate will cause
deactivation of the alkaline phosphatase, resulting in decreased cTnI
or CK-MB readings.
i-STAT CHEM8+ cartridges require the use of:
1. whole blood collected in non-heparinized capillary tubes, evacuated
tubes, or syringes, as long as sample is tested immediately upon
draw,
2. heparinized whole blood collected in balanced heparin syringes or
capillary tubes, or
3. heparinized whole blood collected in evacuated tubes containing
lithium or sodium heparin, as long as the tubes are filled to capacity.
Fill Requirements
Fill blood collection tubes with and without anticoagulant and syringes with
anticoagulant to capacity. Incomplete filling of anticoagulated tubes and
syringes will cause higher heparin-to-blood ratios, which will decrease ionized
calcium results and may affect other results. Under filling blood collection
tubes with and without anticoagulant may also cause decreased PCO
2
, HCO
3
and TCO
2
results.
Partial-draw blood collection tubes (evacuated tubes that are adjusted to draw
less than the tube volume, e.g. a 5 mL tube with enough vacuum to draw only
3 mL), with or without anticoagulant, are not recommended for blood gas or
CHEM8+ cartridge analysis because of the potential for decreased PCO
2
,
HCO
3
and TCO
2
results. Care must also be taken to eliminate “bubbling” of
the sample with a pipette when filling a cartridge to avoid the loss of CO
2
in
the blood.
Mixing
Gently mix blood (whether anticoagulated or not) immediately to avoid
clotting. Invert a blood collection tube at least 10 times. Roll a syringe
vigorously between the palms for at least 5 seconds each in two different
directions, then invert the syringe repeatedly for at least 5 seconds, then
discard the first two drops of blood. Note that it may be difficult to properly
mix a sample in a 1.0 cc syringe.
Exposure to Air
Avoid exposing the sample to air when testing venous samples for ionized
calcium, pH, PCO
2
and TCO
2
. Test immediately if the sample is drawn into
a blood collection tube. Expel any air bubbles immediately if the sample is
drawn into a syringe or leave an air bubble next to the plunger and do not
allow it to move through the sample.
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