80 y/oF AMS

[Handsome Robb]

Just wanted to point out that right now, even with the best clinical acumen and diagnostic criteria and scoring systems like SIRS, there still must be some type of objective lab in the diagnostic mix.
This was the basis of why lactate was thrown into the mix to begin with.

This is a very good point. I see no reason why even urban EMS systems can't do POC lactate testing. Like myself and others have said it probably wouldn't change much, potentially more aggressive fluid resuscitation which wouldn't be a bad thing, and nipping the ER in the ***. The problem is, and it's been pointed out, the only FDA approved device isn't manufactured anymore.

I'm all for forward movement in EMS. I think that there are patient populations we can truly make a difference in morbidity and mortality, such as these patients we're discussing m, but unfortunately we're limited by the tools provided to us.

I'm not sure if our ERs use iSTATs or anything similar for bedside lactates when we bring these patients in. In my experience its a STAT lab draw with cultures, fluids and sometimes antibiotics if there's a real solid case prior to the labs coming back.