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Articles by James H. Nichols
Showing articles by "James H. Nichols"
Article
October 2014
Point-of-care cardiac markers in the Emergency Department are safe, reduce admissions and do not impact on the 4-hour target
Barnsley Emergency Department (ED), which recruited patients into the RATPAC trial, initiated a point-of-care (POC) pathway for low-risk chest pain patients from December 2011.
All patients who underwent POC testing for chest pain between December 2011 and July 2012 were identified. Patient notes were then examined...
Cardiac markers
Point-of-care testing
Process optimization
Troponins
Article
October 2014
Umbilical-cord blood gas analysis
The pH, base excess and pCO2 (acid-base status) of arterial blood flowing through the umbilical cord provides valuable objective evidence of the metabolic condition of neonates at the moment of birth; a notion that has assured a role for the blood gas analyzer in hospital delivery suites in cases of suspected fetal...
Blood gases/acid-base
Neonatology
Glucose
Lactate
Hemoglobins
Kidneys/fluids
Article
October 2014
POCT in emergency rooms: One key factor for process streamlining with Lean Management
In the past years, emergency rooms (ER) all over Germany, especially those of maximum-care hospitals, have been faced with an increasing number of patients. This is caused by a variety of factors, including demographic changes, inflexible ambulant services and an overreaching demand for healthcare services.
ER...
Cardiac markers
Point-of-care testing
Process optimization
Hemoglobins
D-dimer
Troponins
CRP
Article
July 2014
Postmortem CO-oximetry
CO-oximetry provides the means for automated spectrophotometric measurement of the concentration of total hemoglobin (ctHb) in blood and the percentages of the four hemoglobin derivatives that total hemoglobin comprises: oxyhemoglobin (O2Hb); deoxyhemoglobin (HHb); carboxyhemoglobin (COHb); and methemoglobin (MetHb)....
Blood gases/acid-base
Hemoglobins
Article
May 2014
Laboratory use of umbilical cord blood for critically ill infants
Neonates nearly always experience their single largest day of blood loss on the day of birth due to admission laboratory testing. The term "admission laboratory testing" refers to the initial blood tests done when a baby is born and admitted to the NICU.
Total circulating blood volume in a 3.5 kg term newborn is 280...
Point-of-care testing
Blood gases/acid-base
Hemoglobins
Article
May 2014
Oxygen saturation – better measured than calculated
Ensuring adequate oxygen delivery to tissues is a prime objective of acute/critical medical care. There is no routinely available method for directly monitoring tissue oxygenation; instead clinicians must depend on available indirect measures.
Although not the only factor to be considered, measurement of the amount of ...
Blood gases/acid-base
Article
January 2014
The Role of Cardiac Biomarkers in the Diagnosis and Management of Patients Presenting with Suspected Acute Coronary Syndrome
Reprinted from Ann Lab Med 2013 Sep; 33(5):309-18.
Christenson E, Christenson RH: "The role of cardiac biomarkers in the diagnosis and management of patients presenting with suspected acute coronary syndrome".
Myocardial infarction (MI) is the leading cause of death in the developed world. Biomarkers have an...
Cardiac markers
Troponins
Article
October 2013
Age-adjustment of the D-dimer cut-off value to improve the exclusion of thromboembolic events in older patients
With increasing age, an unspecific rise of fibrin degradation product in blood is observed. Thus, the D-dimer test to rule out thromboembolic events has a high false positive rate in elderly patients.
In 2010, Douma et al introduced a formula to adjust D-dimer cut-off values for age in outpatients >50 years: Age ×...
Coagulation/fibrinolysis
D-dimer
Article
September 2013
Developing quality control strategies based on risk management: The CLSI EP23 guideline
How do errors occur in the laboratory and what can we do to prevent errors?
Any test can and will fail if incorrectly performed or operated under the wrong conditions. The role of the laboratory director is to determine those conditions and to understand test limitations in order to prevent laboratory errors....
Point-of-care testing
Quality assurance
Hemoglobins
D-dimer
Troponins
Article
July 2013
How to use high-sensitivity cardiac troponin assays most effectively in clinical practice
Recently developed high-sensitivity cardiac troponin (cTn) assays can measure approximately 10 times lower concentrations with high precision (coefficient of variation, <10 % at the 99th percentile of the upper reference limit) than conventional assays, and can measure cTn concentrations in at least 50 % of a reference ...
Cardiac markers
Troponins
CRP
Natriuretic peptide
Kidneys/fluids
