I have tried (in vain) to find out whether the pH and LDH measurements in
the original data for the BTS guidelines were measured using analytical
methods and equipment certified for use on such fluids.
I am dubious that we may be operating outwith the recommendations of the
analyzer and kits. Where does that leave us in liability or CPA terms ?
Suggest you check your analyzer kit inserts and blood gas analysers. (Or pH
meters)
with best wishes
Richard
Richard Mainwaring-Burton
Consultant Biochemist
Queen Mary's Hospital
Sidcup, Kent
020-8308-3084
-----Original Message-----
From: Williams David G (RLN) City Hospitals Sunderland - Clinical Scientist
[mailto:[log in to unmask]]
Sent: 29 March 2007 14:46
To: [log in to unmask]
Subject: Drowning in Various Fluids
Many thanks to those who responded (as ever) to this question.
I gather (from some respondents) that there seems to be a marked increase in
requesting an increasing munber of analytes on pleuritic and ascitic fluids.
The consensus seems to be that there is not a great deal of evidence to
justify such multiple requests
There was a paper published in the Annals a few years back about this:-
Annals of Clin Biochem 2001 Vol 38 p311-322 for a good review of
pleural fluid testing.
I append the results of audits carried out by list members, I assume that
they will not object to them being posted out to the list (if not then my
apologies)
I also append the British Thoracic Societies Guidelines from 2003 which
basically recommend pH, LDH, protein and glucose and nothing else
biochemical, except that cholesterol and triglycerides may be required in
the case of a suspected chylothorax.
One point that seems to be ignored is that the levels of analytes in pleural
fluid at least need to be compared with current plasma levels of he same
analytes, so a sample of blood should accompany any request for fluid
measurements.
Once again, many thanks
David G Williams
<<Fluid Audit Summary 0305.doc>> <<Fluid Standards 0305.doc>>
<<PleuraDiseaseEffusion BTS Guidelines.pdf>> <<PLEURAL FLUID AUDIT
STANDARDS.doc>>
------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/
|