Dear Frank
We have recently surveyed blood gas analysis in the Welsh region and find
only 1 lab reporting solely H+. Another (ours) reports both H+ and pH but I
rather wish I'd had the courage to remove pH like you did and not bow to the
protests from the old school anaesthetists. The remaining 13 labs report
just pH.
Like you we have been persuaded by the Hooper-Marshall School of Philosophy
so I was somewhat disappointed that so few others in Wales had apparently
made the conversion. In your local context w-ould it be so difficult for
your chest physician to give you the guidelines he or she is working to and
get them converted to H+?
Dave Hullin
Dr D A Hullin
Department of Clinical Biochemistry
Royal Glamorgan Hospital
Ynysmaerdy
Llantrisant
CF72 8XR
Tel: 01443 443358
> -----Original Message-----
> From: Frank Wells [SMTP:[log in to unmask]]
> Sent: 04 June 2003 21:17
> To: [log in to unmask]
> Subject: Hydrogen ion
>
> In 1998, following the Annals article by Hooper, Marshall and Miller
> (Log-jam in acid base education and investigation: why make it so
> difficult?, Ann Clin Biochem 1998 35 85-93) I set up a series of meetings
> with our respiratory physician and a lead ITU consultant and we changed
> from reporting pH to hydrogen ion. Educational material, including sample
> cases, was placed on the Intranet, together with an explanation of the
> reasons for the change. Every ward was supplied with a laminated acid base
> diagram, with some additional basic information on utilisation of hydrogen
> ion. It all went a lot more smoothly than I feared, and I have had
> occasional questions from junior staff but no significant problems. I made
> the change partly because I believed in it (even I could work out what was
> going on with most of our gas results!) and partly because, in the West
> Midland Region, following a meeting at which Dr Hooper spoke, there seemed
> to be a broad support for the change.
>
> Recently, I have had a chest physician asking me to change back, saying
> that most guidelines use pH and almost all other hospitals do, and we are
> out of step. Could I ask what others are doing? I realise that the users
> of the mailbase may not be entirely representative, but I would very much
> like to know the state of play at present.
>
> Frank Wells
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