RE: Assaulting patients with added tests

So you tick the <ABDO PAIN> box on our A&E request form - and the small type tells you that you are getting U&E, glucose, LFT, amylase and calcium.

If we go down this other road, will we need to check that the patient's permission has been obtained every time a doctor phones and asks for a test to be added onto a previous specimen?

Elliott

-----Original Message-----
From: Mike Collins [mailto:[log in to unmask]]
Sent: 21 April 2004 17:35
To: [log in to unmask]
Subject: Re: Assaulting patients with added tests

Craig
Here's a different A&E scenario.
Patient has abdo pain.
U&E glucose sent to lab.
1 - 2 hours later cas ring up to ask why no amylase result on the server. Sample recovered and amylase added. 1 to 5 hours after that a ward rings up to ask for the LFT result. Sample dug out again and LFT added. Alternatively with a no add-ons policy the patient has been bled twice more.

How much simpler and cheaper to do U&E, LFT amylase on every abdo pain.

Mike Collins

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Mike Collins
BMS3
Clinical Biochemistry & Immunology
Leeds Infirmary, Old Medical School
Thoresby Place, Leeds LS1 3EX
UK
44 (0) 113 392 2915
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NB I will be leaving on April 23rd 2004
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>>> Craig Webster <[log in to unmask]> 21/04/2004 17:08:55 >>>
The not doing of tests comes down to whether you are consulting an
expert in the laboratory or just ordering a test. If we take the example
of tumour markers, one of the most popular requests from A&E at the
moment goes along the lines of: Stomach pain ? Cause with U&E, Ca, LFT,
Thyroid Function tests, CEA, CA125 (if female), CA199, CA153, PSA, AFP &
HCG should we just do this because its been ordered or actually think
about the finite resources the NHS has and actually try and direct
appropriate investigations?

I'm interested because it does seem from some of the arguments that the
lab should be a black box and just do what we are told.

Regards
Craig

Craig Webster
Principal Clinical Biochemist
Nottingham City Hospital

-----Original Message-----
From: owner-acb-clin-chem-gen [mailto:owner-acb-clin-chem-gen]
Sent: Wednesday, April 21, 2004 3:17 PM
To: cwebste1
Subject: Re: Assaulting patients with added tests

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