New noninvasive test can ID internal bleeding in ED

If your patient is bleeding internally, you can know this in seconds instead of waiting for blood test results to come back by using a new noninvasive test for hemoglobin, developed by Irvine, CA-based Masimo.

Several ED nurses at the University of California San Francisco Medical Center were given "super-user" training on this new needle-free hemoglobin test, SpHb, and then trained the rest of the ED nurses.

"I also developed several posters to educate nurses on the new devices," says Andrew Maruoka, RN, MS, assistant manager of the ED. "There are a few minor differences in the operation of the equipment, but it really is as simple as a traditional pulse oximetry monitor. This technology simply requires slipping a sensor on a patient's finger and reading the result."

ED nurses already are using Masimo's Radical-57 Pulse CO-Oximeters, and they will begin using the noninvasive hemoglobin function shortly. "In the ED, noninvasive hemoglobin is a welcome addition that I anticipate will play a great role in our assessment and triage efforts," says Maruoka.

Having immediate, continuous access to hemoglobin levels will allow nurses to detect and treat internal bleeding faster, says Maruoka. Until now, ED nurses have never had the ability to monitor hemoglobin levels in real time. "We can continuously trend a physiologic parameter we normally only assess by spot checks," Maruoka says. "With the ability to see a patient becoming more anemic in real time, we can better anticipate resuscitative measures such as blood transfusions."

ED nurses will be able to make an immediate diagnosis of chronic anemia and more quickly identify patients with active bleeding from gastrointestinal bleeding, aneurysm, or trauma, as well as those who present with anemia secondary to cancer. "These patients will benefit from immediate real-time detection, intervention and treatment, potentially leading to better outcomes and recoveries," Maruoka says.

There also is increased safety for ED nurses, since the hemoglobin test is noninvasive, says John Viljoen, MD, clinical professor of anesthesiology at Loma Linda (CA) University School of Medicine. "I expect that ED nurses will be hearing and seeing much more about this in the near future," he says. "Given its potential to create clinical efficiencies, decrease patient wait times, and increase patient throughput in the ED, it represents a valuable and compelling alternative to waiting for lab results."


Masimo's noninvasive and continuous total hemoglobin monitoring (SpHb) can help clinicians quickly detect chronic or acute anemia, identify occult bleeding earlier, and more effectively manage blood transfusions. The test will be commercially available in the first half of 2009. The single device list price ranges from $5,000 to $10,000, based on features and quantity. For more information, contact: