I would like to see our agency expand our care even more to allow some additional diagnostic tools to be used, such as checking electrolyte levels, checking for presence of cardiac markers and enzymes, and ultrasound capabilities. Right now we are in a budget crunch, so for right now that type of improvement is on the back burner.
We agree on many things, but I have to respectfully point out/ask.
I have worked with the istat for troponin in the hospital, it is way too sensitive and tempermentl machine for a rig I think. If you dropped a piece of equipment with any weight on the desk it was on it would error out. With one test taking roughly ten minutes and the lab controls required, it doesn't seem like it would be of much benefit. Especially since even in the ED all it seems to serve is hich service the pt is admitted to. Not to mention it makes cards real angry when you call them with the 0.1ng positive result. I am not sure it is a good idea to have EMS worry about an admitting dx. and the service.
As for other electrolytes, I think serious considertion should be given to the cost/benefit ratio. I think it would be a major challenge to get hospitals to accept your lab values, which means a pt will be double billed in all likelyhood. Also if you are not going to have treatment protocols for it, would it really be anything more than a toy? Does your service have the time or desire to maintain lab certification for such?
Ultrasound I can see having several good uses. (Ultrasonography is very much underutilized in the US compared to Europe) Probably definately worth the money and training involved.
Would you be willing to share the reasons you think the labs would be beneficial or justify the cost and time in the prehospital setting?