It would be helpful to know what other Labs quote for this. My own view is
that we should be cautious and quote a narrow range for prophylaxis (eg 0.4
- 0.8mmol/L) as this covers the majority of patients safely. Severely
disturbed/manic patients may need higher levels, but I would expect
specialist medical staff to realise this and treat the patient rather than
the result. The Pharmacist at a local secure Unit is worried that doctors
will actually treat the result, and inappropriately reduce doses in violent
patients with Li levels of, say 0.82mmol/L if it is flagged as "high". She
feels that it would be dangerous for her to tell them to effectively ignore
the flagged result, as they may then ignore a flagged potassium.
We can each see the other's point of view. How do other Labs cope?
Looking forward to hearing from you.
Angela
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