Element POC Blood Gas & Electrolyte Analyzer - Rapid, Portable, Wireless Critical Care
Photo of Element POC and close up The NEW Element POC advances the speed, versatility and convenience of clinical diagnostics with the advantage of handheld portability. With less than 100 uL of sample, Element POC delivers accurate blood chemistry, electrolyte, hematology, acid-base and blood gas results in as little as 35 seconds.
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EASY TO USE
  • Critical chemistry, metabolic parameters, electrolytes, hematocrit, blood gas and acid base results within 35 seconds of sample introduction, with as little as 100 μL of blood.
  • One convenient Test Card platform simplifies inventory management.
  • Significant cost-per-test savings versus other hand-held analyzers.
  • Room temperature Test Card storage eliminates warm-up period and frees refrigerator space.
  • Wi-Fi/Bluetooth Connectivity
  • Species-specific reference ranges
  • Simplified patient data entry with convenient touchscreen.
3 Steps: Insert Test Card, Fill sample entry port, View results in 35 seconds
 
The Element POC™ Blood Gas & Electrolyte Analyzer from Heska advances the speed, versatility and convenience of clinical diagnostics with the advantage of handheld portability. With less than 100 µL (about 2 drops of blood) of sample, Element POC delivers accurate blood chemistry, electrolyte, hematology, acid-base and blood gas results in as little as 35 seconds.

CLINICAL APPLICATIONS GUIDE

The links in this guide outline clinical application of the following: 

Ionized Calcium icon IONIZED CALCIUM
Electrolytes - Sodium, Potassium, Chloride icon ELECTROLYTES: Sodium, Potassium, Chloride
lactate icon LACTATE
GLUCOSE
Acid-Base icon ACID-BASE: pH, Bicarbonate, Total Carbon Dioxide, Base Excess, Anion Gap
Blood Gas icon BLOOD GAS: Oxygen and Carbon Dioxide
Renal icon RENAL: Creatinine
Hematology icon HEMATOLOGY: Hematocrit, Hemoglobin


Ionized Calcium icon IONIZED CALCIUM

Measurement of ionized calcium is the most accurate way to diagnose hyper and hypocalcemia conditions. When testing total calcium levels on standard blood chemistry analyzers, the parameter reflects total body calcium in the bound and unbound forms. Whereas, the ionized calcium measured on the Element POC™, is the unbound bioavailable form of calcium that is active in metabolic processes and most relevant to the clinical picture.

Clinical Presentation: Patients suffering from hypocalcemia are typically very weak or seizuring. Most commonly they are lactating females with eclampsia but can also be individuals with nutritional or parathyroid disease.

Those affected with parathyroid disease, or other conditions causing hypercalcemia are often subclinical and unless there is obvious neoplastic process, renal disease or bone disorder, the finding leads the clinician on a diagnostic trail to determine the underlying cause.

CLINICAL APPLICATION
  • Diagnostic and treatment decisions:
        – Verify abnormal total calcium measurements
        – Plan additional tests (e.g., chemistry panel, CBC, urinalysis, rectal palpation, imaging)
        – Calcium gluconate administration
        – Fluid type, rate, volume, additives
  • Monitoring-serial testing:
       – Success of treatment
       – Determine chemotherapy remission
       – Post-operative condition
       – Neoplasia relapse

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Electrolytes icon ELECTROLYTES: Sodium, Potassium, Chloride
Knowledge of electrolyte disturbance is imperative to further determine and characterize many disorders. In most cases, elevations and decreases of sodium, potassium and chloride are secondary to another disease process that is affecting organ function in such a way that electrolyte balance is altered.

With the exception of iatrogenic conditions, most electrolyte disturbances are secondary to renal disease, endocrine disease, nutritional deficiencies or toxicities.

Clinical Presentation: These patients may show no signs, or depending on the type of disturbance, they can have neuromuscular, neurological or cardiovascular abnormalities consistent with disruption of normal cell function and body fluid distribution.

CLINICAL APPLICATION
  • Diagnostic and treatment decisions:
        – Plan additional tests (e.g., chemistry panel, CBC, urinalysis)
        – Fluid therapy type, rate, volume, additives
        – Specific medications to shift balance, additives
  • Monitoring-serial testing:
       – Acute imbalances
       – Chronic conditions
       – Fine tuning fluid therapy
       – Success of drug therapy
       – Drug side effects

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Lactate icon LACTATE
Blood lactate is a by-product of anaerobic glycolysis. Elevated plasma concentration (lactic acidosis) indicates some degree of metabolic derangement. The most common causes of elevated lactate are hypoperfusion secondary to shock or GDV and hypoxia due to severe anemia or asthma.

Clinical Presentation: Dog and cat patients with lactic acidosis are typically in critical condition and in need of immediate therapeutic intervention to reverse the lactatemia and resolve the underlying cause.

CLINICAL APPLICATION
  • Diagnostic and treatment decisions:
        – Plan additional tests (e.g., blood chemistry, CBC, imaging)
        – Degree of stomach necrosis in GDV
        – Limb viability in feline aortic thromboembolism
        – Oxygen delivery
        – Fluid type, rate, volume, additives
  • Monitoring-serial testing:
       – Trends for prognostic indicator
       – Track fitness in horses

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Glucuse icon GLUCOSE
Extreme highs and lows of blood glucose call for immediate intervention.

Significant elevations are typically due to diabetes mellitus with or without ketoacidosis. Extremely low blood glucose can be idiopathic but is often caused by eclampsia, starvation, hypothermia, insulinoma, septicemia or insulin overdose.

Clinical Presentation: Depending on severity, the condition of these patients may vary from subclinical to critically ill.

With diabetes, depending on the duration of the illness, typical signs include polyuria and polydipsia with or without polyphagia, anorexia, weight loss and signs associated with ketoacidosis.

Hypoglycemic animals may be weak, collapsed, seizuring or comatose.

CLINICAL APPLICATION
  • Diagnostic and treatment decisions:
        – Plan additional tests (e.g., chemistry panel, CBC, urinalysis, glucose curve, fructosamine)
        – Insulin therapy
        – Glucose administration
        – Oxygen delivery
        – Fluid type, rate, volume, additives
  • Monitoring-serial testing:
       – Insulin adjustments
       – Glucose curves
       – Septic patients
       – Success of therapy

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Acid Base icon ACID-BASE: pH, Bicarbonate, Total Carbon Dioxide, Base Excess, Anion Gap
The body uses a buffering system to maintain the blood pH within a very narrow margin of 7.35 to 7.45. Excess acid or base ions caused by various disease processes can adversely affect the blood pH unless compensated for by renal or respiratory mechanisms.

Knowledge of Acid-Base status allows the clinician to deliver targeted and in many cases life-saving intervention.

Clinical Presentation: In chronic cases, patients may be fairly well compensated and not in any immediate distress. Patients with significant alterations of blood pH are typically in critical condition requiring rapid assessment and therapeutic measures to correct the imbalance. Acute trauma, toxic ingestion, respiratory distress, cardiovascular shock, adrenal insufficiency, urinary obstruction, GDV or gastrointestinal obstruction may be observed.

Simple Acid-Base disturbances can be interpreted based on the relationship of pH, HCO3- and PCO2 to each other. Interpretation of lab results, coupled with the history and physical exam, will help determine if the patient is suffering from a primary metabolic or respiratory process.

CLINICAL APPLICATION
  • Diagnostic and treatment decisions:
        – Plan additional tests (e.g., chemistry panel, CBC, urinalysis, Imaging, centesis, trocharization, surgery)
        – Fluid type, rate, volume, additives
        – Oxygen therapy
        – Resuscitation
  • Monitoring-serial testing:
       – Success of treatment
       – Trends useful as prognostic
       – Anesthesia
       – Post-operative condition

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Blood Gas icon BLOOD GAS: Oxygen and Carbon Dioxide
Blood gas analysis measures the pressure exerted by dissolved oxygen and carbon dioxide (pO2, pCO2) in arterial blood and is the industry standard for assessing respiratory function.

Often times it is not clear if abnormal breathing is caused by disease of the respiratory tract, heart, red blood cells or other body systems.

Use of venous blood is roughly accurate for carbon dioxide levels when using a venous reference range, but is of no value for assessing oxygen levels. Knowledge of blood gas status is especially important when administering anesthetic drugs in patients that have severe surgical conditions or high risk factors.

CLINICAL APPLICATION
  • Diagnostic and treatment decisions:
        – Oxygen delivery
        – Stability for surgical intervention
        – Anesthetic protocol
        – Artificial respiration
        – Intubation
        – Tracheotomy
        – Fluid type, rate, volume, additives
  • Monitoring-serial testing:
       – Anesthesia in high risk patients
       – Thoracotomy
       – Major abdominal procedures
       – Treatment success
       – Wean or increase supplemental oxygen as indicated

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Renal Icon RENAL: Creatinine
Renal insufficiency is one of the most common disorders diagnosed in veterinary patients. Due to the functional reserve of the kidneys, affected animals typically do not show clinical signs of chronic renal disease until they have lost nearly 75% of renal function. Patients with renal disorders may present for routine appointments, or in a crisis state that must be immediately diagnosed and addressed.

Clinical Presentation: Depending on severity, clinical signs of renal insufficiency may include: lethargy, weight loss, uremic breath, oral ulceration, polyuria/ polydipsia, anorexia and/or vomiting.

When considered with signalment, history, physical exam findings and comparison to other tests, the creatinine value provided by the Element POC™ can help the clinician quickly assess a patient’s renal function and state of hydration.

CLINICAL APPLICATION
  • Diagnostic and treatment decisions:
        – Screen renal health
        – Confirm hydration status
        – Detect renal compromise
        – Plan additional tests (e.g., chemistry panel, CBC, urinalysis, imaging)
  • Monitoring-serial testing:
       – Renal function over time
       – Success of therapy
       – Drug side effects

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Hematology icon HEMATOLOGY: Hematocrit, Hemoglobin
Knowledge of red blood cell percentage and oxygen carrying capacity provides important information for guiding diagnostic and treatment decisions. Anemia is common in both acute and chronic disorders and depending on the rate and duration of blood loss, emergency measures may be indicated. Elevations of hematocrit are also important in assessing hydration and disorders such as polycythemia.

Clinical Presentation: Depending on severity, clinical signs of anemia can include lethargy, weakness, collapse, respiratory distress and cardiovascular compromise. In chronic cases, the patient may be subclinical.

Elevated hematocrit, or hemoconcentration, caused by dehydration from anorexia, vomiting, diarrhea or polycythemic conditions may cause lethargy, weakness or seizures.

CLINICAL APPLICATION
  • Diagnostic and treatment decisions:
        – Plan additional tests (e.g., CBC, chemistry panel, imaging)
        – Oxygen therapy
        – Blood product administration
        – Fluid type, rate, volume, additives
  • Monitoring-serial testing:
       – Trend anemia over time
       – Success of therapy

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SPECIFICATIONS

Measured Parameters Measurement Range
Blood Gas Parameters  
pH 6.5–8.0
pCO2 5–250 mm Hg
pO2 5–750 mm Hg
Electrolyte Parameters
Na+ 85–180 mmol/L
K+ 1.5–12.0 mmol/L
CL- 65–140 mmol/L
iCa++ 0.25–4.0 mmol/L
Chemistry Parameters
Creatinine 0.3–15.0 mg/dL
Glucose 20–700 mg/dL
Lactate 0.30–20.00 mmol/L
Hematocrit (Hct) 10–75% PCV
Calculated Parameters
cTCO2, cHCO3, BE (ECF), AG, cSO2, cHgb
Reference Ranges
Species Dog, Cat and Horse
Operating Parameters
Sample volume > 92 μL
Analysis time ~ 35 seconds after sample introduction.
Sample throughput ~17/h
Sample Processing
Sample type Whole blood from arterial, venous or capillary source should be tested immediately after drawing to obtain most accurate results.
Sample containers 1–3 mL syringe: Li, Na or balanced heparin, or without anticoagulant (test immediately).
Calibration Duration
Test Card 165 seconds
Data Processing (Host)
Processor Marvell™ PXA 320 at 806 MHz
Software Microsoft® Windows Mobile 6.5 Classic
Memory 256 MB RAM; 1 GB Flash
Display PenTile® 3.5 in color VGA, super bright 650+ NITS
Bluetooth Class II, v 2.1 EDR, up to 32' range
Wireless LAN Tri-mode IEEE® 802.11a/b/g, up to 98' range
Electrical
AC input (Reader) 100–240 Vac, 0.5 amps, 50–60 Hz
Battery (Reader) Lithium ion rechargeable
Battery (Host) Lithium ion rechargeable
Environmental
Operating temperature (Host) 14°F to 122°F (-10°C to 50°C)
Operating temperature (Reader) 59°F to 86°F (15°C to 30°C)
Operating humidity (Host) Up to 95% relative humidity, non-condensing
Operating humidity (Reader) Up to 85% relative humidity, non-condensing
Barometric pressure (Reader) 400–825 mmHg (53–110 kPa)
Dimensions (L x W x H)
Host 5.78 in x 3.03 in x 1.06 in
Reader 8.46 in x 3.35 in x 2 in
Weight
Host 12.5 oz
Reader < 1.1 lb


SAMPLE HANDLING GUIDELINES

Test Syringes Evacuated Tubes
pO2 • 1 or 3 ml plastic, non-iced
• Test in less than 30 min
• Not recommended
pH/pCO2 • 1 or 3 ml plastic
• Test in less than 30 min
• Without anticoagulant
• With Li or Na heparin
Ionized Calcium (Ca++) • 1 or 3 ml plastic
• Without anticoagulant
• With Li or Na heparin only if < 10 IU/ml
• With balanced heparin only if < 70 IU/ml
• Without anticoagulant
• With Li or Na heparin only if < 10 IU/ml
Hematocrit (Hct) • 1 or 3 ml plastic
• Immediate testing is recommended in order to avoid RBC settling. (NOTE: Re-suspension of RBC requires an air bubble of significant volume within the syringe prior to inverting syringe to mix.)
• Without anticoagulant
• With Li or Na heparin only (do not use EDTA).
All other tests • 1 or 3 ml plastic  
* To obtain the results that most accurately reflect patient status, samples should be tested as quickly as possible after sample draw.
 

1.) What kinds of tests can be run on the Element POC instrument?

2.) What technology does the Element POC utilize?

3.) What type of sample is used?

4.) How much blood is required to run an Element POC test card?

5.) Where do I store the Element POC test cards?

6.) Do the test cards require warm-up before use?

7.) What is the shelf-life of the Element POC test cards?

8.) What species does the Element POC have reference ranges for?

9.) Which parameters on the Element POC system are measured and which are calculated?

10.) Does the Element POC require calibration?

11.) Do I need to run controls for the Element POC?

12.) Does the Element POC require maintenance?

13.) Why does the Element POC have software updates?

14.) Can the Element POC transmit results to an external computer?

15.) Can I print my results from the Element POC without connecting to my computer?

16.) Can the Element POC results be transmitted to my practice management software?

17.) If the Element POC instrument is exposed to extreme heat or cold, will it still produce reliable results?

18.) How long do the rechargeable batteries last?

19.) How many result records can the Element POC store?




1.) What kinds of tests can be run on the Element POC instrument?

The Element POC (epoc®) analyzer provides 11 measured and 6 calculated parameters on one test card that is stored at room temperature. Results are provided 35 seconds after sample introduction. Measured parameters include:
  • pH
  • pCO2
  • pO2
  • Na+
  • K+
  • Cl-
  • Ca++
  • Creatinine
  • Glucose
  • Lactate
  • Hct
Calculated Parameters:
  • cTCO2
  • cHCO3-
  • BE (ecf)
  • BE (b)
  • AG
  • cSO2
  • cHGB
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2.) What technology does the Element POC utilize?

Element POC (epoc) utilizes a single-use test card that is stored at room temperature and contains gold electrodes and calibration fluids to calibrate the analyzer prior to each sample analysis. Potentiometric, amperometric and conductometric measurements are utilized to generate all measured parameters. Measured parameters are then utilized to generate calculated parameters. Element POC has a detachable hand-held display (host), and a separate reader that accepts the test card. The two pieces communicate wirelessly via Bluetooth.

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3.) What type of sample is used?

Whole blood from arterial, venous or capillary source can be used. A minimum sample volume of at least 92 uL is required for analysis. Untreated whole blood should be analyzed immediately after drawing to obtain most accurate results. Alternatively, lithium, balanced or sodium heparin anticoagulated whole blood may also be tested. Balanced heparin is recommended for the most accurate ionized calcium results. Over-dilution of sample with sodium heparin may impact accuracy of sodium results.

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4.) How much blood is required to run an Element POC test card?

A minimum sample volume of at least 92 uL of whole blood from arterial, venous or capillary source is required for analysis. Untreated sample should be analyzed immediately. Lithium, balanced or sodium heparin may be utilized as anticoagulant. Balanced heparin is recommended for the most accurate ionized calcium results. Over dilution of sample with sodium heparin may impact accuracy of sodium results.

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5.) Where do I store the Element POC test cards?

Test cards for Element POC (epoc) are stored at room temperature (59 to 86 degrees F).

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6.) Do the test cards require warm-up before use?

Test cards for Element POC (epoc) are stored at the same room temperature as the analyzer, and do not require any warm up time.

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7.) What is the shelf-life of the Element POC test cards?

Element POC (epoc) test cards have up to 180 days dating from the date of manufacture.

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8. What species does the Element POC have reference ranges for?

Element POC (epoc) has programmed reference ranges for Dog, Cat, and Horse for both venous and arterial samples. Results outside the normal range are flagged. This represents a significant advantage over other handheld, cartridge-based technologies that do not contain species specific reference ranges. All values, including flagged values outside the species specific reference ranges, will transmit via Bluetooth or WiFi to your practice management software (Heska integration required) or epoc wireless printer (sold separately).

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9. Which parameters on the Element POC system are measured and which are calculated?

Element POC (epoc) provides results 35 seconds after sample introduction. All results are available from a single test card which is stored at room temperature. This represents a significant advantage over other handheld, cartridge-based technologies that require you to choose which parameters you need, or the more expensive alternative of running multiple consumables to get all the parameters that Element POC gives you from one test card. Measured parameters include:
  • pH
  • pCO2
  • pO2
  • Na+
  • K+
  • Cl-
  • Ca++
  • Creatinine
  • Glucose
  • Lactate
  • Hct
Calculated parameters:
  • cTCO2
  • cHCO3-
  • BE (ecf)
  • BE (b)
  • AG
  • cSO2
  • cHGB
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10.) Does the Element POC require calibration?

Element POC (epoc) single use test cards (stored at room temperature) contain calibration fluids to automatically calibrate the analyzer prior to each sample analysis. This process is completed prior to sample introduction which decreases the potential of clotting in the test card and generating errors. This represents a significant advantage over other handheld, cartridge-based technologies that require sample to be introduced prior to the calibration process.

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11.) Do I need to run controls for the Element POC?

Element POC (epoc) does not require an external control to be run on the analyzer in order to ensure accurate results. The analyzer conducts a number of quality control checks automatically as part of its operation, including a calibration prior to every sample analysis (see: Does the Element POC require calibration?). External quality controls are available from Heska in order to support lab protocols requiring the use of controls. Contact your Heska representative for more information.

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12.) Does the Element POC require maintenance?

Element POC (epoc) host and reader do not require any significant maintenance. Both the host and reader contain rechargeable batteries which will need to be recharged periodically based on use. The analyzer can be operated while on AC power. Bi-annual software updates are required to run the latest test cards. These updates are transmitted wirelessly and do not require specialized cables.

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13.) Why does the Element POC have software updates?

Software updates allow the Element POC (epoc) to benefit from any updates to the test card manufacturing process, as well as any refinements to the internal calibration and/or changes to the host software, species specific reference ranges, etc.

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14.) Can the Element POC transmit results to an external computer?

Element POC (epoc) utilizes Bluetooth wireless connectivity to download results to your clinic PC. If > 32 feet is desired between the test area and your PC, epoc can tie into your clinic’s wireless network for data download. Use HeskaView Integrated Software to view results, print reports and/or export results into Excel. Heska’s Data Capture Utility will integrate results from epoc into practice management software products that support Heska lab analyzer integration.

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15.) Can I print my results from the Element POC without connecting to my computer?

Yes. The Element POC (epoc) Bluetooth printer with rechargeable battery is coming soon. This thermal printer uses a peel-and-stick media to make it easy to keep results where you want them!

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16.) Can the Element POC results be transmitted to my practice management software?

Yes. Element POC (epoc) utilizes Bluetooth wireless connectivity to download results to your clinic PC. If additional range is desired (greater than ~32 feet), epoc can tie into your clinic’s wireless network for data download. Use HeskaView Integrated Software to view results, print reports and/or export results into Excel. Heska’s Data Capture Utility will integrate results from epoc into any practice management software that supports Heska lab analyzer integration.

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17.) If the Element POC instrument is exposed to extreme heat or cold, will it still produce reliable results?

Element POC (epoc) is designed to operate between 59 to 86 degrees F. Internal sensors will warn the operator if the epoc reader is outside of temperature, pressure or humidity limits. These alerts allow the user to restore the epoc to the specified environmental conditions prior to introducing a test card.

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18.) How long do the rechargeable batteries last?

Element POC (epoc) has a detachable hand-held display (host), and a separate reader that accepts the test card. The two pieces communicate wirelessly. Both the host and reader use a lithium ion rechargeable battery. The reader will conduct up to 50 tests on a single charge, while the host battery will last for up to 70 tests.

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19.) How many result records can the Element POC store?

Element POC (epoc) has 256 MB of built in RAM. This is enough memory to store approximately 3000 separate results. You can also transmit results to your clinic PC and store as many results as your computer storage capacity will hold. (See: Can the Element POC transmit results to an external computer?)

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