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Dear all A quick burst of googling just found : BTS guidelines for the management of pleural infection CWH Davies, FV Gleeson, RJO Davies, on behalf of on behalf of the British Thoracic Society Pleural Disease Group, a subgroup of the British Thoracic Society Standards of Care Committee - Thorax 2003; 58 (Suppl II): ii18 -ii28 which states that pleural fluid pH is an 'auditable parameter' in the investigation of pleural effusions. This puts a considerable burden on junior doctors in the A&E department. Do our colleagues from Reading & Oxford, whence the authors hale, have a view on what is clearly a contentious issue, Were the laboratory invited to comment ? Do they currently offer the service ? If so, under what precautionary conditions ? It is also of note that earlier discussion on the mailbase regarding pO2 measurement on patients on home oxygen therapy was alos as a result of a BTS guideline. with best wishes Richard Richard Mainwaring-Burton Consultant Biochemist Queen Mary's Hospital Sidcup, Kent 020-8308-3084 -----Original Message----- From: # David Ricketts [mailto:[log in to unmask]] Sent: 14 December 2005 10:30 To: [log in to unmask] Subject: Re: Pleural Fluid pH We do not do pH on pleural fluids, or even allow fluids that do not follow strict criteria from being opened in the lab. We work in a high-risk TB area, so all fluids that fail to follow strict collection conditions are processed in the Micro CAT3 room (where they routinely do all of their pleural fluids), before we run them through the main analyser for Protein (is this CE marked!). pH through the BGA is a no no. Regards, David -----Original Message----- From: James Ritchie [mailto:[log in to unmask]] Sent: 14 January 2005 12:08 To: [log in to unmask] Subject: Pleural Fluid pH We have been asked by our pulmonologists to provide stat pH measures on pleural fluid effusions. This measure is evidently useful in determining the treatment course of these effusions. Now here's the rub. Our bench blood gas instruments are not FDA approved to do this measure and the manufacturer is saying that performing them will void our maintenance contract. Performing them on our POC ABG instrument (Bayer Rapidpoint) appears to foul the electrodes resulting in the necessity to replace a cartridge prematurely. We were considering using a pH meter as a POC instrument but that is not an approved POCT in our state. A pH meter in the lab will not easily meet the TAT needs of our clinicians. How are others handling this problem? I'd love to hear of some truly creative solution. Thanks, Jim Ritchie, Ph.D. Emory University Atlanta, GA 30322 ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/ Want FREE help and advice to quit smoking? Ring Enfield & Haringey Smoking Cessation Service on 0800 085 6258 or visit www.quitsmoking.uk.com for information and specialist support. CONFIDENTIALITY NOTICE The contents of this e-mail are confidential and may also be privileged. If you are not the addressee of this e-mail you may not copy, forward, disclose or otherwise use it in any form whatsoever. If you have received this e-mail in error please immediately telephone 020 8887 2345, and destroy and delete the message from your computer. NORTH MIDDLESEX HOSPITAL NHS TRUST ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/ ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/