Or possibly stabilise at the GP surgery?
Yusuf
Yusuf Gray
Biomedical Scientist Team Manager – Point of Care Technologies
Derbyshire Pathology
University Hospitals of Derby and Burton NHS Foundation Trust
Royal Derby Hospital
Telephone 01332 788537
Mobile 0737 938 0799
[log in to unmask]<mailto:[log in to unmask]>
www.uhdb.nhs.uk<http://www.uhdb.nhs.uk/>
[A screenshot of a cell phone Description generated with high confidence]
This e-mail, and any files transmitted with it, are confidential and intended solely for the use of the individual to whom it is addressed. If you are not the intended recipient please destroy this message, delete any copies held on your systems, and notify the sender immediately. You should not retain copy or use this e-mail for any purpose, nor disclose all or any part of its content to any other person.
From: Clinical biochemistry discussion list <[log in to unmask]> On Behalf Of Sharpe, Peter
Sent: 01 March 2019 13:31
To: [log in to unmask]
Subject: Re: Pseudohyperkalaemia
We are currently auditing all phoned out K results > 6.5 mmol/l. There are 6-7 every day phoned to primary care and over the last 6 weeks of the audit all were pseudohyperkalaemias – the majority of patients were sent urgently to A&E.
One has to really wonder about the value of K as part of the GP electrolyte profile – it is certainly causing a lot of harm. Other ways to resolve – better, more regular transport, GP centrifuges, phlebotomy hubs. We remove potassium results from all samples > 24 hours old, and put a warning/disclaimer on all those between 6-24 hours. Perhaps we need to remove all > 6 hours or lower?
Kindest regards
Peter
Dr Peter Sharpe
Consultant Chemical Pathologist
Associate Medical Director, Research & Development
Southern Health & Social Care Trust
Ext: 60869
Tel: 028 38360696
Fax: 028 38334582
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Misra, Shivani
Sent: 01 March 2019 13:02
To: [log in to unmask]<mailto:[log in to unmask]>
Subject: Re: Pseudohyperkalaemia
Such a difficult issue
A more controversial solution is to de-couple electrolytes from a GP-requested renal function altogether.
Is NA+ and K+ as part of routine renal function in a GP setting adding much value or causing more harm?
In my experience the vast majority of spurious cases occur in people having routine bloods ..…but of course if there was a legitimate reason to request electrolytes then it could be included as a separate request
Shivani
Shivani Misra MRCP, FRCPath, PhD
Consultant in Metabolic Medicine & Diabetes
Imperial College Healthcare NHS Trust
From: Clinical biochemistry discussion list <[log in to unmask]<mailto:[log in to unmask]>> on behalf of "JONES, Stuart (BARKING, HAVERING AND REDBRIDGE UNIVERSITY HOSPITALS NHS TRUST)" <[log in to unmask]<mailto:[log in to unmask]>>
Reply-To: "JONES, Stuart (BARKING, HAVERING AND REDBRIDGE UNIVERSITY HOSPITALS NHS TRUST)" <[log in to unmask]<mailto:[log in to unmask]>>
Date: Friday, 1 March 2019 at 12:55
To: "[log in to unmask]<mailto:[log in to unmask]>" <[log in to unmask]<mailto:[log in to unmask]>>
Subject: Re: Pseudohyperkalaemia
This was becoming a major issue for us too. We were finding that many cases of spurious hyperkalaemia (primarily due to delay between bleed and spin) were not being picked up. We’ve had to have a complete re-think on sample reception logistics and we now stipulate that all primary care ‘critical’ hyperkalaemias have to be reviewed by the on call consultant biochemist before being phoned to out. These can be very difficult decisions to make!
Stuart
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Mike Addison
Sent: 01 March 2019 12:38
To: [log in to unmask]<mailto:[log in to unmask]>
Subject: Pseudohyperkalaemia
This year alone I have heard of 3 cases of individuals amongst a small cohort of friends and acquaintances being contacted by their respective GP practices to be told to take themselves urgently to A&E because of high potassium results in blood taken at the GP surgery. In the past this also happened to my wife. The anxiety and disruption caused to these patients whose repeat potassium results were normal was considerable. The cost implication to the NHS is also a factor as in A&E many more tests, other than potassium, were carried out and patients were in A&E for a considerable period of time.
I have been too long retired to have kept up to date in this field but someone must have done audits of hyperkalaemia in samples from GP practice and the prevalence of true versus pseudohyperkalaemia in them. Do GPs check for known causes of pseudohyperkalaemia before rushing the patient off to hospital? Are there guidelines for this? And is this such a problem that GP should have POCT in the surgery?
Are you all prepared for Brexit?
Dr Mike Addison
------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 who posts and they are solely responsible for all message content. The ACB does not monitor posts. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.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/
********************************************************************************************************************
This message may contain confidential information. If you are not the intended recipient please inform the
sender that you have received the message in error before deleting it.
Please do not disclose, copy or distribute information in this e-mail or take any action in relation to its contents. To do so is strictly prohibited and may be unlawful. Thank you for your co-operation.
NHSmail is the secure email and directory service available for all NHS staff in England and Scotland. NHSmail is approved for exchanging patient data and other sensitive information with NHSmail and other accredited email services.
For more information and to find out how you can switch, https://portal.nhs.net/help/joiningnhsmail
------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 who posts and they are solely responsible for all message content. The ACB does not monitor posts. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.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 who posts and they are solely responsible for all message content. The ACB does not monitor posts. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.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/
The Information and the Material transmitted is intended only for the
person or entity to which it is addressed and may be Confidential/Privileged
Information and/or copyright material.
Any review, transmission, dissemination or other use of, or taking of
any action in reliance upon this information by persons or entities
other than the intended recipient is prohibited. If you receive this in error,
please contact the sender and delete the material from any computer.
Southern Health & Social Care Trust archive all Email (sent & received)
for the purpose of ensuring compliance with the Trust 'IT Security Policy',
Corporate Governance and to facilitate FOI requests.
Southern Health & Social Care Trust IT Department 028 375 63600
------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 who posts and they are solely responsible for all message content. The ACB does not monitor posts. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.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/
********************************************************************************************************************
This message may contain confidential information. If you are not the intended recipient please inform the
sender that you have received the message in error before deleting it.
Please do not disclose, copy or distribute information in this e-mail or take any action in relation to its contents. To do so is strictly prohibited and may be unlawful. Thank you for your co-operation.
NHSmail is the secure email and directory service available for all NHS staff in England and Scotland. NHSmail is approved for exchanging patient data and other sensitive information with NHSmail and other accredited email services.
For more information and to find out how you can switch, https://portal.nhs.net/help/joiningnhsmail
------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 who posts and they are solely responsible for all message content. The ACB does not monitor posts.
ACB Web Site
http://www.acb.org.uk
Green Laboratories Work
http://www.laboratorymedicine.nhs.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/
