Evaluation of the i-STAT portable clinical analyzer for use in a helicopter

We evaluated the performance of the i-STAT Portable Clinical Analyzer (PCA) for use in a helicopter with the analyses performed by the flight nurses. Imprecision and initial split-sample comparative studies were performed in the Hospital Laboratory and Clinical Chemistry Laboratory. Day-to day imprecision (CV) ranged from 0.5 to 6.7% in the clinical laboratories and 0.5 to 5.3% in the helicopter with urea nitrogen and glucose determinations giving the highest values. Comparison studies between the PCA and the Kodak Ektachem E700 and the Beckman Astra 8 gave acceptable results, although urea nitrogen did show a bias in the high range (mean difference 4.91 and 3.69 mmol/L respectively). It was not considered medically significant for the anticipated patient population of the PCA in our hospitals. Comparison studies of patient specimens between the PCA in the helicopter and the clinical laboratories showed no significant differences, with the exception of glucose. Lower glucose values were obtained in the laboratory due to the time lag between specimen collection in the helicopter and analysis in the laboratory.