]One of the first things I do when I start shift is the check lab values. Do you call MD with any low H&H, or do you only call with critical values?
Aug 10, '06
I only call critical values if I am working in the acute hospital. If I am in long term care, I fax the labwork over to the doctor.
Aug 10, '06
hi! i tend to look at the amount of change & the time between last draw. if there is a signifigant drop, in say 1 day, i would most likly call but is it is low and there has been no significant changes, i [font='times new roman']probably would not call.
does your place of business have any written policy about reporting lads? i would see whats in place first. where i'm at now the lab super calls md after verifying critical labs.
Aug 11, '06
I work on a surgical floor where we have a fair number of joint replacements and hysterectomies. If I called with every low H/H, I'd spend all morning on the phone getting cursed out by MDs! I just call with critical lows or, like fgoff, sharp drops. Also if the patient is symptomatic and/or the vitals are unstable -- esp tachy with dropping BP. Figure anything else can wait until the doc gets in.
Aug 25, '06
I agree with all of you reagarding the reporting of lab values especially one critical like the Hemoglobin. You must assess your pt individually, remember that they are all different. You can not compare a 50 yr. old with an ORIF to a 70 yr old with an ORIF. Also don't forget to assess your pt. first, look for symptoms of hypoxia and even if they are not symoptomatic, get an oxygen sat, check previous levels, medical hx such as CAD, MI, anything that may not show obviously. We usually report anything below 8/24. Remember you must always CYA. Hope it helps. This would apply to any lab value.
Disclaimer: Always follow your facility protocols and policies. this is not meant to be medical education or advice.
Aug 26, '06
Quote from nursechito
Also don't forget to assess your pt. first, look for symptoms of hypoxia and even if they are not symoptomatic, get an oxygen sat, check previous levels, medical hx such as CAD, MI, anything that may not show obviously. [/U][/I]
And remember, a person with critical H/H values can have O2 sats of 100 percent yet still be hypoxic...
Aug 26, '06
I only call on critical H&H's or if there is a specific order to call if H&H is < ?? We have several pts on our unit that run chronically low, so unless someone has had a a big change since the day before, has a critical value or specific order, I will just mention it to the Dr's when they round.
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