So I get a call from the lab..... - page 2

by mindlor

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Your pt has a critical high potassium of 4.8.....seriously? Then in the same sentence....your other pt is set for dialysis....tell the dialysis nurse to stop.....their creatinine is 4.1 and dialysis may not be... Read More


  1. 0
    Our lab calls with "critical" values. They have to, and they have to chart what RN they spoke with about it.

    I've never gotten advice about how to deal with these values from them, however. Occasionally, they will ask questions about how the samples might have been collected, or whatever, especially if there is a drastic change.
  2. 3
    We had one lab tech at my previous job who would just leave us shaking our heads in amazement. During 5am rounds, one patient had a blood glucose of 25. Our protocol was to do a stat blood glucose by blood draw. So we do the test, and immediately feed him. *20* minutes later, get a call from the lab tech.
    "Oh my God, your patient in bed so-and-so! Make him eat NOW!! His blood sugar is dangerously low!"

    Right, because we were just waiting for you to confirm HOW low it was before we fed the poor man.
  3. 4
    Had that happen to me once... I've had type 1 diabetes since age 4 and use an insulin pump and have reasonable blood sugars. But using insulin, highs and lows happen.

    After a normal check up there was a major delay in the lab and it took over 2 hrs. to get blood drawn. It was over my lunch hour and I knew my blood sugar was dropping and had turned off my insulin pump an hour earlier to mitigate, but my glucose tablets were in the car and I was worried if I left I'd be put on the bottom of the list. After labs I went to my car, ate a few glucose tablets and waited until BS came up to 80, then went back to my busy day.

    About 4 hours later I got a call from my doctor's office... my blood sugar was 55 and I needed to treat it STAT! The PA was so nice but was clueless my low BS from hours earlier was no longer a problem. She kept telling me I needed to treat it or she would call EMS. I finally told her I'd drink some juice and hung up...
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    Imagine how the doctors feel, with tons more patients than us: "Hi Dr. Grumpy, sorry to wake you up, but Mr. Smith in bed 10 has a white count of 22. Yesterday? 25...28 the day before that... Yes, I know it's trending down but I still have to call you..."

    We get audited and any critical values must be reported to the physician within an hour of receiving them...there are some guidelines in place where expected out-of-whack results don't need to be called in certain situations, thank god. But a lot of time you're still just bothering the MD because protocol says so, even if common sense says otherwise.
    GrnTea, redhead_NURSE98!, KelRN215, and 1 other like this.
  5. 19
    Hate getting calls from the lab. Wish they'd call with good news for once. "That patient whose lytes you've been repleting all night has a potassium of 4.1 and and a mag of 2.0, well done "
    GrnTea, EricJRN, Sinman, and 16 others like this.
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    What I love is that I can enter a comment when I request the lab in the computer. So for a PTT, I might write "heparin drip" and hope they read that. And I turn my drips OFF for about a minute or five then do my draws if it's a line, make sure there is a waste and all that jazz. And still get somebody incredibly excited on the phone an hour later. No I'm not gonna call the doc you goof. I'm gonna follow my orders, thanks.

    Or the metabolic panel that I write "dialysis patient" on and I get all sorts of yammering chitchat over a potassium and a creatinine. Yeah. Look that's what dialysis is for, they will fix this crap in about two hours. The doc knows it's like that or there wouldn't be dialysis orders on the chart. I'm gonna stop writing comments, no one reads them.
    merlee and rammstein like this.
  7. 0
    Quote from sapphire18
    Imagine how the doctors feel, with tons more patients than us: "Hi Dr. Grumpy, sorry to wake you up, but Mr. Smith in bed 10 has a white count of 22. Yesterday? 25...28 the day before that... Yes, I know it's trending down but I still have to call you..."

    We get audited and any critical values must be reported to the physician within an hour of receiving them...there are some guidelines in place where expected out-of-whack results don't need to be called in certain situations, thank god. But a lot of time you're still just bothering the MD because protocol says so, even if common sense says otherwise.
    You guys consider a white count in the 20s critical? Ours aren't critical until 100.
  8. 1
    Quote from sarakjp
    Hate getting calls from the lab. Wish they'd call with good news for once. "That patient whose lytes you've been repleting all night has a potassium of 4.1 and and a mag of 2.0, well done "
    Hahaha, that would be awesome!
    redhead_NURSE98! likes this.
  9. 0
    Quote from blondy2061h

    You guys consider a white count in the 20s critical? Ours aren't critical until 100.
    Hey, I don't make the rules, I just work there! Lol. But yes...a white count above like 25 is a problem...have never seen one above maybe 40. Maximum.
  10. 0
    i always chuckle at the " mr blabla has a panic level troponin of 0.29 . am i supposed to start running around screaming and panic- ing? lol


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