Document Detail

Calcium, magnesium, and phosphorus: emergency department testing yield.
MedLine Citation:
PMID:  9189187     Owner:  NLM     Status:  MEDLINE    
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.
W D Rose; J E Martin; F M Abraham; R L Jackson; J M Williams; E Gunel
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
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:
Created Date:  1997-07-31     Completed Date:  1997-07-31     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9418450     Medline TA:  Acad Emerg Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  559-63     Citation Subset:  IM    
Department of Emergency Medicine, West Virginia University School of Medicine, Morgantown 26506, USA.
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MeSH Terms
Blood Chemical Analysis / utilization*
Calcium / blood
Diagnostic Tests, Routine / utilization*
Electrolytes / blood*
Emergency Service, Hospital / statistics & numerical data
Hospitals, Teaching
Laboratory Techniques and Procedures
Magnesium / blood
Phosphorus / blood
Practice Guidelines as Topic
West Virginia
Reg. No./Substance:
0/Electrolytes; 7439-95-4/Magnesium; 7440-70-2/Calcium; 7723-14-0/Phosphorus

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