JPINFV
Gadfly
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RTs do a lot of the actual vent management and fine tuning.
learning lab blood values?
- Thread starter blindsideflank
- Start date
RTs do a lot of the actual vent management and fine tuning.
Ewok Jerky
PA-C
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At first I didn't really like reference "ranges". I am terrible at straight memorization. Instead, I memorized a normal set of labs, so I could at least recognize high or low values. With experience comes recognition of critical values.
a "normal" set of labs
Na:140
K:4.0
Cl:110
CO2: 24
BUN:10
Cr: 1.0
H/H- female: 14/40, male: 16/45 (I might be off on this one, it can vary widely)
WBC: 4.5-11 (ish)
platelets: 150-450
looking at your patient, what would you expect to see in their labs? would you expect something to be elevated or decreased? Can you explain the labs based on your patients history?
example: your 58y/o patient eats motrin like candy for chronic back pain. presents with abd pain x3 days and dark stool. what would you expect to see on labs?
example: your 34 y/o patient presents with n/v/d x6 days. has not been eating or drinking much because of the vomiting. what would you expect on labs?
a "normal" set of labs
Na:140
K:4.0
Cl:110
CO2: 24
BUN:10
Cr: 1.0
H/H- female: 14/40, male: 16/45 (I might be off on this one, it can vary widely)
WBC: 4.5-11 (ish)
platelets: 150-450
looking at your patient, what would you expect to see in their labs? would you expect something to be elevated or decreased? Can you explain the labs based on your patients history?
example: your 58y/o patient eats motrin like candy for chronic back pain. presents with abd pain x3 days and dark stool. what would you expect to see on labs?
example: your 34 y/o patient presents with n/v/d x6 days. has not been eating or drinking much because of the vomiting. what would you expect on labs?
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Ewok Jerky
PA-C
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Meh. This thread seems to have lost most peeps interest. Perhaps you can pose a more challenging scenerio?
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We do it all day long in the OR, we mostly just use an ABG from the i-stat, which gives us the gas as well as the most important lytes and a hgb. Depending on the facility, a CRNA might order pre-op labs, as well.
Our family practice NP and the ACNP's I know certainly do. When I flew it was part of my job to look at an ABG and a chem and CBC, and make treatment decisions based on them (we carried blood, K+, Ca+, Mg+, LR, insulin, etc.).
Even as an ICU nurse I was expected to know normal ranges and be able to recognize trends (worsening renal function, for instance) and at a minimum, implement appropriate protocols.
I think that is a great approach.
blindsideflank
Forum Lieutenant
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Ya I've always remembered it as
Ph 7.35-7.45
Na 135-145
K. 3.5-4.5
Why I asked about who else would interpret these is because I'd like to investigate how they learned to do it. Here we have a little knowledge but it seems as though most of it comes from chatting with others etc. it seems silly that when we fly and use istat's or look at hospital charts that we don't really have a formal and standardized education (or expectation) as to what level we should be interpreting and utilizing our data.
Just another case of a lack of standardization that hurts our profession as a whole. Ill keep searching for some formal courses or continuing Ed stuff I can suggest to clinical Ed.
Ph 7.35-7.45
Na 135-145
K. 3.5-4.5
Why I asked about who else would interpret these is because I'd like to investigate how they learned to do it. Here we have a little knowledge but it seems as though most of it comes from chatting with others etc. it seems silly that when we fly and use istat's or look at hospital charts that we don't really have a formal and standardized education (or expectation) as to what level we should be interpreting and utilizing our data.
Just another case of a lack of standardization that hurts our profession as a whole. Ill keep searching for some formal courses or continuing Ed stuff I can suggest to clinical Ed.
Last edited by a moderator:
Ewok Jerky
PA-C
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with EMS education geared towards the pre-hospital provider, I don't see lab values or critical care medicine really being integrated. Especially with the focus of so many educators on telling war stories and preparing your for TRAUMA!!!
Especially at the Basic level, I think there are more of us in the IFT business than Rescue. And we could certainly understand our patients better if we were able to interpret the labs in the patients chart, or be able to take a detailed report from the sending facility. But then again, would that understanding change your treatment during the transport? Probably not. So there is no realy clinical benefit to have such knowledge as an EMS provider.
I haven't met that many nurses (in my short career) that can actually "interpret" labs. Yes they can recognize a critical value, but they don't understand how this relates to the patient, their physiology, or their disposition. I am not knocking nurses, but the nursing role, just like the EMS role, is not focused at that aspect of medicine. MDs, PAs, NPs, and peeps who work in Critical Care know this level of medicine because they went to school for it and were taught it. If you want to learn more in medicine, you need to learn it for yourself by buying books, talking with other providers, and asking questions...or maybe going for formal education. Unfortunately, I don't have any specific recommendations for the OP in this respect.
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Back in the day, when I was a new paramedic going through CCEMTP and CFP and all that, I used Mosby's Pocket Guide to Fluid, Electrolyte, and Acid-Base Balance. This was quite a while ago but I remember finding it pretty useful.
Now I have Lab Values Pro on my phone and it's pretty good. I don't use it often but I open it occasionally. It gives a brief explanation and differential for each value.
Now I have Lab Values Pro on my phone and it's pretty good. I don't use it often but I open it occasionally. It gives a brief explanation and differential for each value.