Original Article

Technique for Improved Patient Care: Initial Experience with the GEM-6

Schumpert Medical Center, Shreveport, LA

^* Direct communications to: Beverly Parault, R.N., C.C.P., Medical Perfusion Dept., Schumpert Medical Center, P. O. Box 21976, Shreveport, LA 71120-1976.

Abstract

(J. Extra-Corpor. Technol. 20[1]: p. 46–51 Spring 1988) In our institution, a “stat” lab is not available in close proximity to the OR. The problem of receiving lab results quickly (within 5-8 minutes) while on cardiopulmonary bypass was a persistent problem. Therefore, the decision was made to evaluate the GEM-6, a relatively new on-line blood gas, electrolyte, and hematocrit monitor for the heart-lung machine. for the first 30 days of use, simultaneous results were obtained from the GEM-6 and the hospital lab. Our lag time receiving results was greatly reduced and the lab values compared favorably with the hospital lab. The least reliable value with the original cartridge and software was the hematocrit levels. Hematocrits measured by the GEM-6 consistently were 2-5% higher than the hospital lab results. This problem appears to be proportionately related to the patient’s serum sodium level. Due to decreased work load on OR personnel, reliability, quickly obtainable results, and multiple parameters available with the GEM-6, we instituted use of the GEM-6 in January 1987. Through the use of Quality Assurance monitors and comparative Recovery Room first blood gases as QA monitors on open heart patients, documentation of improved patient care through the use of this on-line instrument is provided. Lab values readily available to the perfusionist can indeed result in the “fine tuning” of the pump run with improved patient care.