Lab Values for EMS

1. Lab ValuesforEMS An Introduction to Laboratory Values Christopher G Graham Specialty Care Paramedic Paramedic Instructor Mobile Medical Response Educational Services Inc. Saginaw, MI

2. What’s to know? • Its just a lab value, right? • I’m not a Dr. …… that’s his job! • If it says H (high) or L (low) that’s good enough for me! Are YOUjust good enough for this career?

3. You are the Sleuth • Detectives in your discipline • When, what, where, why, how • So ………….. Why not? • Professionals on the rise • Do police officers use drug dogs as pets? • Do firefighters use a 5” line to water flowers? • Do radiologists use images for their photo album? • Do politicians use speeches as a verbal exercise? • Should EMS Professionals use our resources as a paperweight?

4. Why Lab Values?

5. Do I have you convinced yet?

6. But there are too many!  • How do I know which ones are which? • Does it really make a difference? • Where do I start? • Ughhhhh!!!!     Its as easy as going to CHURCH

7. Let’s Start with the BASICS

8. Comprehensive Panel

9. Hepatic Panel

10. Unknown Infection

11. Renal Panel

12. Cardiac Panel

13. Hematologic Panel

14. 16 Total Lab Values

15. Alanine Aminotransferase

16. Alkaline Phosphatase

17. Aspartate Aminotransferase

18. Bilirubin

19. Creatinine

20. Blood Urea Nitrogen

21. White Blood Cells

22. Red Blood Cells

23. Hematocrit

24. Hemoglobin

25. Platelets

26. Carbon Dioxide

27. PH

28. Creatine Kinase

29. Myoglobin (Serum)

30. Prothrombin Time

31. Partial Thromboplastin Time

32. International Normalized Ratio

33. Red Cell Distribution Width

34. Reading a Lab Sheet

35. Putting it all together

36. Case Study 1 • 85 yo male c/o Abdominal Pain • Nausea/vomiting • Short of breath • Mild abdominal distention • BP168/92 Pulse 110 Respirations 24 SPO2 97% • Iv 0.9% Sodium Chloride at 125ml/hr • 12l ekg reveals NSR with no ectopy • BLG 119 • Skin, pale, warm, moist • LAB Values

37. Case Study 2 • 72 yo Female c/o shortness of breath and Abdominal Pain • Been consistent for 12 hours with no relief from home treatment • BP 172/99 HR 48 R 20 SPO2 99% • BLG 219 • EKG marked Sinus Bradycardia with first degree AV block • LABS

38. Case Study 3 • 48 yo male c/o L flank pain • Marked decrease in urination and peripheral edema • BP 160/80 P 110 R 20 SPO2 99% • BLG 124 • EKG Sinus Tach with no Ectopy 12l non diagnostic • Skin pink/warm/dry • LABS

39. Case study 4 • 18 yo female c/o general weakness, dizziness, short of breath • Present for last couple weeks, worse with exercise • BP 130/70 P 130 R 22 SPO2 99% • BLG 88 • EKG Sinus Tach, 12L non diagnostic • Fever 103.2 F axillary • LABS

40. Case Study 5 • 32 yo Male c/o weakness, dizziness, lethargy • Been present for last couple days • Diarrhea present for last 2 days, black in color, odd odor • BP 100/70 P 110 R 24 SPO2 92% • BLG 98 • EKG Sinus Tach 12L non Diagnostic • LABS

41. Questions? References: American Association for Clinical Chemistry; Lab Tests Online; www.labtestsonline.com 2010 Tilkian, Conover, Tilkian; Clinical & Nursing : Implications of Laboratory Tests Mosby, 1995.

42. Thank You! • Contact Information Christopher G Graham Mobile Medical Response Inc. 834 S Washington Ave Saginaw, MI 48601 989-529-6437 cgraham@mobilemedical.org