Effective Dec. 12, 2025

Background Information: Sites which perform whole blood point-of-care testing will begin a staggered transitioning to the Siemens epoc® from the Abbott i-STAT, starting the week of December 15th, 2025. All sites will complete the transition by summer 2026. There are no changes to Troponin I and INR testing.

Change in Test Procedure:

• The epoc test menu includes:
  • Blood gases: pH, pCO2, pO2, (calculated: HCO3-, sO2, Base Excess)
  • Electrolytes: Sodium, Potassium, Ionized Calcium, Chloride (calculated: Anion gap)
  • Metabolites: Total CO2, Glucose, Lactate, Urea, Creatinine (calculated: adult & pediatric eGFR)
  • Hematocrit and calculated (estimated) Hemoglobin (selected sites only)
• All tests can be ordered individually, except for blood gas panels
• Results will appear in EPR/eChart under the “Biochemistry” header, “Whole Blood Chemistry” sub-header

Patient Impact:

• Allows flexibility of testing venous, arterial, or capillary samples for the entire test menu
• Improved patient safety, especially for pediatrics:
  • New testing methods are less susceptible to assay interference. Interference information is available on the Lab Information Manual
  • Unlike the current system, results will have reference intervals applied according to patient demographics in the downstream reporting systems, making result interpretation clearer
• Reduced number of specimens collected for tests that would normally be referred to another site

System Improvements:

• Expanded test menu for many sites
• Ability to order each test individually (no requirement to order entire test menu as a panel)
• Streamlining of Biochemistry and Hematology services at very low-volume sites

Reminders will be sent by individual sites when going live with the epoc® for routine testing.

See attached table below for list of sites proposed for each phase of the implementation (subject to change).

Access a printable file.

Submitted by: Tamara Burnham, Collaborative Practice Lead

Effective Dec. 12, 2025

Background Information: In an effort to standardize test reporting practices across Manitoba, blood gas panels reported by Shared Health Diagnostic Services will no longer include Total CO₂ (TCO₂).

TCO₂ will continue to be a standalone orderable at all sites.
All blood gas panels will continue to include bicarbonate (HCO₃-), which is the gold standard for assessing acid-base disturbances:

The Mixed Venous (MGAS) test panel will remain unchanged at this time. We are continuing to work on standardizing reporting in collaboration with Respiratory Therapy groups throughout the province, and MGAS specimens are not consistently assessed at every site. We hope to address this in the near future.

System Improvements:

• This will bring laboratory blood gas reporting in line with the practices of the Respiratory Therapy teams in Brandon and the WRHA, providing consistency of result reporting across all health authorities.

Access a printable file.

Submitted by: Tamara Burnham, Collaborative Practice Lead

Effective Dec. 3, 2025 at 1430 hours

Background Information: Defining critical values requires a careful balancing act. In consultation with Clinical Hematology and the Transfusion Medicine Laboratory discipline, critical values for White blood cell count (WBC), Hemoglobin (HGB), and Platelet (PLT) have been revised to reflect clinical demand and patient population as well as overall provincial standardization.

Clinical Practice Change:

• Access the updates to WBC, Hemoglobin, PLT critical values
• All other hemotological critical values remain unchanged

System Improvements:

• To reduce the volume of phone calls between labs and ordering physicians, easing fatigue at both ends without compromising patient care.

Access a printable file.

Submitted by: Tamara Burnham, Collaborative Practice Lead

Beginning Dec. 1, 2025, newborn dried blood spot (DBS) specimens submitted to Cadham Provincial Laboratory (CPL) as part of the Manitoba Newborn Screening (NBS) Program will be routinely screened for CMV (cytomegalovirus).

In addition to being reported to the ordering practitioner, any screen positive newborns will be automatically referred to the Pediatric Infectious Diseases at HSC-Children’s Hospital to assist with confirmatory diagnostics, any necessary additional investigation and early intervention.

Congenital cytomegalovirus (cCMV) infection is considered a leading cause of childhood sensorineural hearing loss. It is estimated that 90 per cent of newborns with cCMV will not show any symptoms at birth. Of those newborns with CMV infection who are asymptomatic at birth, 10 per cent to 15 per cent may develop long-term sequelae, that could include vision loss, hearing loss, and developmental delays.

In the interim, screen positive infants will be immediately referred to Pediatric Infectious Disease for follow-up care. Additional information will be provided as the Congenital Infections Service is established.

Screening results will be available in eChart along with all other NBS results. Complete and accurate completion of the newborn screening card with particular attention to infant demographics and chart number is critical to populating eChart correctly. Please reinforce with your teams the importance of proper completion of the information requested on newborn cards, as the highest rate of reporting failure is as a result of missing or incorrect identifiers.

Access a printable file.

Submitted by: Tamara Burnham, Collaborative Practice Lead

In October 2025, we communicated that the DI Viewer will be upgraded to the latest version as part of the broader Agfa EI Upgrade. We are now ready to provide key information to support readiness for the DI Viewer upgrade scheduled for Dec. 1, 2025.

Resource Materials:
Resource materials have been developed to help orient users to the upgraded system. Users can access them via the links below in the table. These are also available by visiting Agfa EI Upgrade Project Page or PEARL.

• DI Viewer – Quick Reference Guide
• DI Viewer Extended Tools – Quick Reference Guide
• DI Viewer – What’s Changing
• DI Viewer – Image Area
• DI Viewer – Search Area
• DI Viewer Extended Tools – Extended Tools Overview
• DI Viewer Extended Tools – Loading Additional Studies in the Image Area
• DI Viewer – Viewing DI Images in eChart
• Agfa DI Viewer Help Page – Resource Library (see FAQ for how to access this resource)
  Note: On the Agfa Help page, DI Viewer is called “Xero”, and the extended tools are called “Xtend”.

Downtime:

Minimal downtime is anticipated for this change. Should this change, users will be notified of any planned downtime.

Please note: After the upgrade is complete, users should exit the DI Viewer and log back in using the new link to ensure all updates are applied.

Support:

Users are encouraged to reference training materials and FAQs before contacting the Service Desk.

If an answer cannot be found after looking through the training materials or FAQs, users can contact:

1. Service Desk 24/7 at 204-940-8500 or toll-free at 1-866-999-9698.
2. When calling, please follow the automated prompts and select the option for the DI Viewer Upgrade Project to be directed to the appropriate support team.

During go-live, updates will be shared on the Agfa EI Upgrade Project Page.

If you have any general questions about the upgrade, please contact: [email protected]

Previously distributed memos:

• October 28, 2025
• November 1, 2024

Memo from Canadian Blood Services

As part of our continued effort to improve process and meet customer needs, the requisition: Request for Cord/Neonate Blood Testing (F800005) was revised, and a new specimen label Cord/Neonate Specimen Label (L800116) was developed for cord blood and prenatal neonate samples.

Please refer to the memo for a summary of the changes.

Submitted by: Tamara Burham, Collaborative Practice Lead

Change effective: Monday, November 24, 2025

Background Information:

Currently, the Canadian Blood Service (CBS) Cord/Neonate testing requisition includes a peelable label that can be applied onto the patient sample for submission.

Change in Procedure:

Effective November 24, 2025, CBS will no longer be printing additional copies of the historical requisition, and will be transitioning to a requisition separate from the sample label. Please see attached memo from CBS for further details.

Requisition Ordering:

Hard Copies
HSC & SBH – New cord/neonate testing requisitions will be available for request from your site print shops – SAP # 381018. Cord/neonate testing labels will be available to request from your respective blood banks.

Other Facilities – Requisitions and labels will be provided by your site blood bank.

Facilities without a Blood Bank – Direct your requests to CBS Accessioning Lab at 204-789-1085.

Electronic
The cord/neonate testing requisition will be available on the CBS Website – Requisition and Forms, as a one-page fillable requisition which can be filled then printed, or printed and completed manually. It is recommended that the requisition be printed in colour to maintain its identifying feature.

Important Note: CBS will continue to accept samples submitted with previous versions of the requisition after November 24, 2025, however CBS encourages the use of the updated requisition and label.

Contact Information:
Charlie Cacapit, Technical Director, Transfusion Medicine
Shared Health Diagnostic Services
[email protected]

Printable Memo

Submitted by: Tamara Burham, Collaborative Practice Lead

for all clinical staff

An opportunity for all clinical staff to trial and provide feedback on two glucose meters in selecting the new provincial glucose meter equipment at these locations:

Date   November 17, 2025         Time 1600 – 1900 hrs
Portage Regional Health Centre (Nurses Library and Boardroom)
524 5 St SE, Portage la Prairie MB

Date   November 19, 2025         Time 0900 – 1200 hrs
Centre médico-social De Salaberry District Health Centre (Boardroom & Health Corner meeting room)
354 Préfontaine Ave, St. Pierre-Jolys MB

Date   November 21, 2025         Time 0900 – 1200 hrs
Boundary Trails Health Centre (Multi-purpose room)
Hwy 3 & 14, Winkler MB

Trialing New Glucose Meters poster

Submitted by: Tamara Burham, Collaborative Practice Lead