Look at your labs

You have drawn blood, or phlebotomy has come and drawn blood for you. Great. Labs are sent and you go on about your shift. The lab doesn’t call you with any critical values so you figure things must be ok.

And then your patient starts to have more ectopy. His rhythm has definitely changed. Or maybe her blood pressure seems to be lower than normal. Maybe he is more altered than he was.

What’s going on?! This doesn’t make sense. Then you look at your labs… Four hours later…

The values weren’t critical but they are abnormal for your patient. His potassium is 2.9. Her H/H is 7/21, a full three points lower than it was on her last set. His glucose is 61 and he normally runs in the 200’s.

Oh. Ohhhhhh…. Well, shit.

That is four hours that your patient has had abnormal but totally treatable lab values. That is four hours of treatment that your patient did not receive. That is four hours too long. When you send labs or have labs sent for you, you need to remember to check the results. Do not assume that the lab will call you if something is wrong. The lab is responsible for calling when the values are critical or dramatically different than the previous set. However, for some patients, it does not take a critical value for them to exhibit changes. Each person is different, while a hemoglobin and hematocrit of 7/21 may be totally fine for one patient it may be too low for another. One patient may function totally fine with a glucose of 61 while someone that lives higher may exhibit altered mental status. This patient may show no signs at all that their potassium is 2.9 while that patient begins to throw all the ectopy EVER whenever their potassium is less than 3.3. Each patient is an individual and should be treated as such.

Your patient and their labs are your responsibility. Take the minute to give them a check, that minute could save a life.

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5 thoughts on “Look at your labs

  1. As an RN- I remember those ICU days that I was constantly on the phone calling incessantly about results!! It was rare a lab result that got past me. But it is easy to happen with all the pressure involved in our job. Great post.

    Liked by 1 person

  2. I will never forget the time I relied-without looking at the actual numbers-on my aide/LPN (approximately what it would be here in Sweden) who had taken blood glucose on our patients. She told me it was all fine, so that’s what I told the doctor on the rounds. He pointed to the glucose level for the patient we were discussing and said “so you think this is fine?”
    No, I thought it was embarrassing.
    Live and learn!

    Liked by 1 person

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