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  Česky / Czech version Klin. Biochem. Metab., 8/29, 2000, No. 1
 
Which Laboratory Data are of Utmost Priority in Emergency and Critical Patients? 
Drábková J. 1 , Kazda A. 2 

 


Summary:

       The authors evaluated answers to questionnaires considering point-of-care testing (POCT) sent in three variations to prehospital Emergency Medical Services (EMS O 7 respondents), to hospital Accident and Emergen- cy departments (A+E depts O 4 respondents) and to Departments of Anaesthesiology and Resuscitation (ICU™s multidisciplinary O 19 respondents). Prehospital EMS: At the site of the accident or emergency saturation of haemoglobin w ith oxygen by means of pulse oximetry, glycaemia and in selected cases end-tidal CO2 tension during expiration are measured. Blood samples are drawn for later determination of the blood group, possibly carboxyhaemoglobin and alcoholaemia. The A+E departments except the already mentioned parameters require blood gases, Na + , K + , haemoglobin, urea, creatinine and ALT. The limit for the turn-around time is up to 5 minutes for glycaemia and blood gases and up to 30 minutes for other parameters. Glucometers are used in all establishments, multifunctional analyzers only in two of them. The series of required emergency parameters in ICU patients is even more extensive. It includes parameters reflecting the clinical course and comorbidity. From 19 responding multidiscipinary ICU™s eighteen of them use some POCT method. Most often glucometers (14x) and multifunctional analyzers (11x) are mentioned. Quality control is not ensured for 12 glucometers and is insufficient also for 4 multifunctional analysers. Diagnostic plates/strips for cardiomarkers (blood) and for drug overdose and poisoning (urine) are practically not used. Introduction of POCT depends on the situation of the establishments. Close cooperat ion between intensivists and specialists in clinical chemistry is emphasized regarding technical equipment, daily practice, quality control, education of personnel and staff and evaluation.

        Key words: point-of-care testing, emergency medicine, prehospital emergency care, intensive medicine.
       

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