>I've noticed in recent years that juniors are adding C Reactive Protein to
>their "routine blood investigations". We check the blood results on all
>patients who have been discharged without follow up and it is a definite
>trend. Predictably it doesn't seem to effect the management of cases.
Are others also finding this?
Ray McGlone
Lancaster A&E
--> Well, it sort of DOES affect the management of cases... It provides
further delay.
If/when it falls to me to "educate" new SHOs about tests, CRP is one of my
favourite early examples. Initially, I explain to them that it does not
stand for C Reactive Protein or whatever they have been told - it's a
4-letter-word, mis-spelt with a vowel missing...
It's really worth giving them a tutorial about these investigations, with
cases and examples, including the obvious ones like presenting a case who's
obviously septic, with, say a normal WCC or a well person, who accidentally
had an unnecessary blood test sent at resus, which is now "abnormal" and
irrelevant. Once I did a quick audit on urine samples being sent to lab for
MC&S and discovered that some samples done to R/O renal trauma, which came
with say, +ptn, were then "automatically" sent for MC&S, even on young men
from RTAs... This data, I present as well, to emphasize the irrelevance of
irrlevant investigations.
Again, as with other points, the key to getting more efficient work out of
juniors is to put consultants and/or middle-grades on the shop floor to get
involved in juniors' cases, rather than queue-busting.
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