| Calcium, magnesium, and phosphorus: emergency department testing yield. | |
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MedLine Citation:
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PMID: 9189187 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: To investigate how often the ED ordering of stat serum calcium (Ca+2), magnesium (Mg+2), and phosphorus (PO4(-3)) levels affected clinical treatment; to define the diagnoses of patients for whom Ca+2, Mg+2, and PO4(-3) measurements did affect clinical therapy; and to suggest guidelines for more appropriate ordering of these laboratory tests. METHODS: A retrospective chart review was performed in an academic teaching hospital. All adult ED patients who had Ca+2, Mg+2, or PO4(-3) laboratory testing during the 9-month study period were included and evaluated for potential clinical impact of an abnormal Ca+2, Mg+2, or PO4(-3) laboratory test. RESULTS: 1.477 patients had Ca+2, Mg+2, or PO4(-3) measured while in the ED during the study period. Of these, 260 patients (17.6%) had a total of 312 abnormal Ca+2, Mg+2, or PO4(-3) values as defined by results exceeding +/- 15% of normal reference values. Of these, only 5 patients (0.3%) received treatment for abnormal values in the ED, while 75 patients (5.1%) were treated once admitted to the hospital. In this study, the only diagnostic groups to whom significant treatment was administered were diabetic patients (Ca+2 and PO4(-3); alcoholic patients (Mg+2); and renal failure patients (Ca+2, Mg+2, and PO4(-3). CONCLUSION: These results suggest that stat Ca+2, Mg+2, and PO4(-3) levels seldom affect clinical treatment in the ED. The frequency of ordering these tests may be reduced by obtaining Ca+2, Mg+2, or PO4(-3) measurements only for patients known to be at risk for such abnormalities, based on their existing or suspected diagnoses. The authors suggest obtaining these tests, when indicated, on a "non-stat" basis, with the subsequent laboratory results becoming available in-hospital, where treatment is more likely to occur. |
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Authors:
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W D Rose; J E Martin; F M Abraham; R L Jackson; J M Williams; E Gunel |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Academic emergency medicine : official journal of the Society for Academic Emergency Medicine Volume: 4 ISSN: 1069-6563 ISO Abbreviation: Acad Emerg Med Publication Date: 1997 Jun |
Date Detail:
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Created Date: 1997-07-31 Completed Date: 1997-07-31 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9418450 Medline TA: Acad Emerg Med Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 559-63 Citation Subset: IM |
Affiliation:
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Department of Emergency Medicine, West Virginia University School of Medicine, Morgantown 26506, USA. brose@access.mountain.net |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Blood Chemical Analysis / utilization* Calcium / blood Diagnostic Tests, Routine / utilization* Electrolytes / blood* Emergencies Emergency Service, Hospital / statistics & numerical data Hospitals, Teaching Humans Laboratory Techniques and Procedures Magnesium / blood Phosphorus / blood Practice Guidelines as Topic West Virginia |
| Chemical | |
Reg. No./Substance:
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0/Electrolytes; 7439-95-4/Magnesium; 7440-70-2/Calcium; 7723-14-0/Phosphorus |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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