CSCC 2020 VIRTUAL CONFERENCE PROGRAM

“This event is an Accredited Group Learning Activity as defined by the CSCC/CACB Professional Development Program.”
« Cette activité est une activité de formation collective agréée selon la définition établie par le Programme de perfectionnement professionnel de la SCCC et l’ACBC. »

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  Thursday September 10, 2020 

1200-1345 EDT

Top Roundtable Presentations

 Chair: Curtis Oleschuk, Clinical Biochemistry and Genetics, Diagnostic Service of Manitoba, Winnipeg, MB
1200 Welcome
1205 Operator non-compliance - the biggest risk to POCT
Speaker: Julie Shaw, The Ottawa Hospital, Eastern Ontario Regional Laboratories Association and The University of Ottawa, Ottawa ON
Objectives: At the end of the session participants will be able to:
1. Describe challenges in getting buy-in from clinical users of POCT on the importance of following policies and procedures
2. Explain why confirmation of critically high glucose results prior to clinical action is important for patient safety.
3. Describe strategies for educating clinical users of POCT on the importance of quality assurance practices.
Overview: The most significant patient safety risk associated with point-of-care testing (POCT) is operator non-compliance with policies and procedures. Repeat testing when critical POC glucose results are obtained prevents potentially dangerous treatment in the case of an erroneous result. Data from our network of hospitals within the Eastern Ontario Regional Laboratories Association (EORLA) have demonstrated consistent operator non-compliance with the critical glucose repeat policy. Analysis of glucose results from our patients have shown that up to 30% of tests repeated following a critically high initial result are significantly different (>=20%) from the initial result. These findings demonstrate the importance of repeat measurements and the risk to patient safety when POCT policies and procedures are not adhered to by operators.

Operator non-compliance with point-of-care testing (POCT) policies and procedures presents a significant risk to patient safety. Analysis and audit of POCT result data by laboratories provides an opportunity to engage with clinical operators to provide evidence and educate on the importance of compliance with policies and procedures.

1230 Autopsy ethanol testing: challenges and considerations
Speaker:  Mohamed Abouelhassan, Clinical Biochemist, LifeLabs, Toronto ON
Objectives:  At the end of the session participants will be able to:
1. Appreciate challenges of laboratory testing at rural sites
2. Learn common methods for alcohol and drugs-of-abuse testing
3. Learn limitations of utilizing enzymatic assays for ethanol testing for legal investigations and discuss different strategies to overcome these limitations
4. Understand the role of lab testing in managing cases of suspected toxic alcohol intoxication and the importance of efficient communication between the lab and Emergency Department.
5. Appreciate advantages and limitations of urine drug screens.
6. Discuss challenges which may hamper the implementation of definitive testing at small community hospitals.
Overview:  Clinical toxicology testing has a wide range of Medical Legal applications, but it suffers from a number of limitations. These include, but are not limited to, interference, low sensitivity and/or specificity of enzymatic assays and immunoassays, respectively. Even mass spectrometry, which provides a valuable tool for definitive testing and multiplexing, is limited by its low throughput and the need for capital investment and experienced staff which may not be afforded by many laboratories.
These limitations do not significantly impact medical centers at major cities where specimens can be sent to nearby referral labs for definitive testing or by implementing mass spectrometry-based assays; if expertise and budgetary support are available. In contrast, rural laboratories may not have easy access to these resources. Nevertheless, they are accountable for providing reliable results and must develop strategies to fulfill this role.

In this roundtable, I will share my previous experiences in clinical toxicology testing at rural sites. This will include challenges associated with ethanol and toxic alcohol testing for legal cases or Emergency Department, and limitations of urine drug screens and approaches adopted to surpass them.

1255  Unusual Cases in Pediatric Clinical Chemistry
Speaker:  Lawrence de Koning, Associate Professor and Clinical Biochemist, University of Calgary and Alberta Precision Laboratories, Alberta Children's Hospital, Calgary, AB
Objectives:  At the end of the session participants will be able to:
1. Discuss unusual pediatric clinical chemistry cases identified by review of results - especially critically high and low patient results from an acute care pediatric clinical chemistry laboratory.
2. Review stages of the testing process that can cause unusual results.
3. Describe unique physiologic aspects of children and rare pediatric conditions that can cause unusual results.
4. Discuss challenges of laboratory testing at rural sites
5. Summarize common methods for alcohol and drugs-of-abuse testing
6. Explain limitations of utilizing enzymatic assays for ethanol testing for legal investigations and discuss different strategies to overcome these limitations
7. Discuss the role of lab testing in managing cases of suspected toxic alcohol intoxication and the importance of efficient communication between the lab and Emergency Department
8. List advantages and limitations of urine drug screens and discuss challenges which may hamper the implementation of definitive testing at small community hospitals
Overview:  Pediatric clinical chemistry is an extremely stimulating area of laboratory medicine. The dynamic, ever-changing physiology of children can lead to surprising and unusual results which can challenge the comfort levels of clinical chemists. This roundtable will review several cases identified during review of results at the Alberta Children’s Hospital rapid response lab. These cases will focus on laboratory errors, analytical interferences and rare conditions leading to unusual results in children. This roundtable seeks to generate interest and awareness about pediatric clinical chemistry, and pediatric lab medicine in general.