These results were obtained from our blood gas analyser:
pH 7.323
pO2 4.11
pCO2 2.08
Na 149.2 (135 - 148)
K 1.18 (3.5 - 4.5)
THb < lower level of detection
Chloride 129.7 (98 - 107)
The patient was transferred to resus and was about to be treated with potassium and undergo a transfusion. The doctor in resus queried the results as the patient appeared well (or certainly not as bad as the results indicated i.e. was alive!). The repeat sample showed the results to be normal. A clinical incident was raised as apparently 'my gas analyser' was not working properly and could I come and sort it out.
I did ask a question - was the patient on a saline drip? I was asked how did I know?
I say no more!
Merry Xmas to everyone
Helen Peat
Acting Laboratory Manager, Biochemistry Dept
Internal: 15978
Email: [log in to unmask]
Web: http://www.uhb.nhs.uk
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Clinical Biochemistry
Pathology - University Hospitals Birmingham NHS Foundation Trust
Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston
Birmingham, B15 2WB
ð Delivering the best in care
-----Original Message-----
From: ACB Point-of-Care Testing [mailto:[log in to unmask]] On Behalf Of Cresswell, Carol
Sent: 20 December 2012 13:07
To: [log in to unmask]
Subject: Re: POCT teaching scenarios
Use of capillary POCT glucose vs venous Lab glucose in collapsed known diabetic patient.
Pre treatment 1.7 rapidly falling to 0.7 POCT
10 minutes post treatment a venous sample sent to lab 38.8
40 minutes post treatment 2.1 POCT
50 minutes post treatment 30.6 POCT
Results then began to return to more normal range.
Kind regards,
Carol
Carol Cresswell
PoCT Manager
Biochemistry Department
Leazes Wing
Royal Victoria Infirmary
Queen Victoria Road
Newcastle upon Tyne
NE1 4LP
Tel: 0191 2820823
[log in to unmask]
-----Original Message-----
From: ACB Point-of-Care Testing [mailto:[log in to unmask]] On Behalf Of Bates Philip (EAST KENT HOSPITALS UNIVERSITY NHS FOUNDATION
TRUST)
Sent: 20 December 2012 11:17
To: [log in to unmask]
Subject: Re: POCT teaching scenarios
---
This message was sent from an email address external to NHSmail but gives the appearance of being from an NHSmail (@nhs.net) address. The recipient should verify the sender and content before acting upon information contained within.
The identified sender is [log in to unmask]
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Hi
The one that sticks out in my experience is as follows:
Glucose/ketone meter used to measure ketones - nurse put glucose test strip in to do the test - result of 17.8 produced and interpreted as ketones (ketones above 8 reported as 'Hi' but no one picked this up) ..... diagnosed as DKA despite ABG being normal...... commenced on insulin. Patient was a type 2 diabetic of long standing so unlikely to be DKA, and despite no clinical signs of acidosis was treated for DKA for 3 days. We now emphasis relating the clinical condition to the results produced - if they look suspicious then repeat/double check/investigate.
Hope this is of use
Regards
Phil
Phil Bates
Trust PoCT Coordinator
East Kent Hospitals University NHS Foundation Trust Canterbury Kent CT1 3NG
01227 766877 x74088
07500 826111
[log in to unmask]
-----Original Message-----
From: ACB Point-of-Care Testing [mailto:[log in to unmask]] On Behalf Of Michael Ryan
Sent: 20 December 2012 11:10
To: [log in to unmask]
Subject: POCT teaching scenarios
Dear Colleagues,
I am looking for case histories that reflect POCT issues for use in training student nurses. All contributions gratefully accepted.
Happy christmas,
Michael Ryan
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