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We have a number of protocols for use in A&E and AAU MEDA (Medical Admission Profile) U&E,Creat(= UEC),LFT,CRP (the answer to life , the universe....),Calcium Group(CG),Glucose,Full Blood Count(FBC) FNOF (# neck of femur) as MEDA, but no CRP plus TSH if not done within last 3 months ABDO (abdo pain) as MEDA but no Calcium Group, plus amylase CP1 (Chest pain 1st sample) as MEDA plus Troponin, Clotting Studies(CS) and Cholesterol but no CG CVA (Stroke) as MEDA plus Chol & CS and ESR TRAU (Trauma) UEC,LFT,AMYL,FBC,CS APPX (Appendix) UEC,CRP,FBC Moreover, we do not do TSH for A&E cases unless relevant clinical info, such as Atrial Fibrillation; this is blocked by the computer system. These were agreed with the A&E / AAU consultants and work quite well. Michael ________________________________ From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Helen Verrill Sent: 12 August 2008 09:34 To: [log in to unmask] Subject: Agreed admission test protocol Having used the Anglia ICE system for GP requests for some time, we are now looking at implementing in the acute setting. This is seen as an excellent opportunity to agree some admission testing protocols for common presentations with A&E and our admission unit (and having seen the requests made during the change of house this could be well overdue!). ICE would allow us to have a 'chest pain screen' but would not prevent other tests being added if thought to be required. So far, we have had two types of response; namely 'you are turning Doctors into machines and removing their clinical autonomy' and 'wonderful, it will mean we get the tests we should have had'. Has anyone implemented this type of approach and if so, how did you agree the protocols to be followed? I've attached our proposed protocol and will collate any responses for the mailbase, Thanks Helen <<Investigation Tariff.doc>> Helen Verrill Consultant Clinical Scientist North Tees and Hartlepool NHS Foundation Trust 01642 624455 Please consider resources and print this e-mail only if essential ------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/