> I was hoping to get some response from our
> trans-atlantic colleagues, as we frequently see in ER,
> the resuscitating physician shouting PR, BP,CVP, Chem7
> and the like which we tend not to see in casualty
> episodes.
I'm not sure what you're asking, Mohammad. Although "ER" was created by
Michael Crichton, who has an MD from Harvard, he has never actually
practiced medicine and undoubtedly his talent is in dramatic effect and not
technical accuracy. My observation has been that the ER in our
facility--which, we are told, is the fourth busiest in the U.S.--is
considerably less frenetic than the TV version.
In 1998, the Health Care Financing Administration issued medical necessity
guidelines that, in essence, specified what laboratory tests were
appropriate for various medical conditions. While the term "CBC" is still
widely used, we don't use "Chem7" any more since it was replaced by the
"basic metabolic profile" specified by HCFA. Typically, ER and Trauma
patients will get the CBC and BMP, with an occasional urine drug screen,
lactate, amylase/lipase, and, of course, CKMB/Troponin. The term "Cardiac
enzymes" is also frequently used on "ER" as well as by our clinicians,
although I take every opportunity to remind them that Troponin is not an
enzyme (nor is myoglobin, which many facilities offer).
I share your interest in transatlantic differences in laboratory practice.
It's one of the reasons I find this listserv so enlightening.
Roger
Roger L. Bertholf, Ph.D.
Associate Professor of Pathology
Director of Clinical Chemistry & Toxicology
University of Florida Health Science Center/Jacksonville
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