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Articles by John G. Toffaletti
Showing articles by "John G. Toffaletti"
Article
January 2011
Moving the Laboratory into the Wards
As healthcare seeks to provide better care with fewer resources, Point-of-Care Testing steps in to move key diagnostic or screening tests to the patient’s bedside. The results can have a significant impact on a patient outcome and operational costs.
Blood gases/acid-base
Process optimization
Glucose
Hemoglobins
Creatinine/urea
Natriuretic peptide
Article
October 2010
"Permissive hypercapnia" finding its place in clinical care
Over the years, as clinicians have learned how to utilize it, permissive hypercapnia has been finding a place in healthcare. However, it is important to bear in mind that numbers do not tell the entire story.
It is imperative to understand the entire clinical picture before you act. For example, an acidic pH of 7.21...
Blood gases/acid-base
Point-of-care testing
Kidneys/fluids
Article
October 2010
Creatinine measurement in the radiology department 2
Clinical laboratory measurement of serum/plasma creatinine concentration has been used to assess patient kidney function for well over 50 years.
With the incorporation of creatinine analyses to blood gas and other point-of-care platforms the test is now available outside the laboratory, at the bedside and in the...
Point-of-care testing
Glucose
Creatinine/urea
Article
July 2010
Lean as a learning system in a hospital ward
PURPOSE – The purpose of this article is to discuss lean as a learning system in a hospital ward.
DESIGN/METHODOLOGY/APPROACH – Discusses lean as a learning system in a hospital ward.
FINDINGS – The Toyota veterans are fond of saying, lean is about “making people before making parts” or, in the wards’ context,...
Process optimization
Information management
Article
July 2010
FAQ concerning the acid-base status of the blood
Some of the frequently asked questions are: Should we use BE (base excess) or SID (strong ion difference) as a measure of a metabolic acid-base disturbance? Is there any difference between BB (buffer base) and SID? Should we use SBE (standard base excess), i.e. BE referring to the expanded extracellular fluid or...
Blood gases/acid-base
Point-of-care testing
Glucose
Lactate
Creatinine/urea
Hemoglobins
Article
April 2010
Benefit of using a D-dimer assay with a high clinical specificity
CONTEXT: Sensitive D-dimer assays have been developed to exclude the diagnosis of deep vein thrombosis (DVT) and have exhibited great success when used in conjunction with a diagnostic algorithm, including pretest probability scoring and a compression ultrasound (CUS).
Improving specificity of D-dimer assays would...
Coagulation/fibrinolysis
D-dimer
Article
April 2010
Creatinine measurement in the radiology department 1
Clinical laboratory measurement of serum/plasma creatinine concentration has been used to assess patient kidney function for well over 50 years. With incorporation of creatinine analyses to blood gas and other point-of-care platforms the test is now available outside the laboratory, at the bedside and in the clinic.
...
Point-of-care testing
Creatinine/urea
Kidneys/fluids
Article
April 2010
Can lean save lives
PURPOSE – The purpose of this paper is to show how over the last 18 months Bolton Hospitals NHS Trust have been exploring whether or not lean methodologies, often known as the Toyota Production System, can indeed be applied to healthcare.
DESIGN/METHODOLOGY/APPROACH – This paper is a viewpoint.
FINDINGS – One’s...
Process optimization
Information management
Article
April 2010
Hyperglycemic control in the ICU
Tight glycemic control (TGC) in the intensive care unit is essential to comprehensive clinical management.
However, TGC that is too aggressive in the wrong patient populations (particularly non-diabetics) can result in hypoglycemia, which brings with it a set of sequelae that can increase morbidity and mortality....
Glucose
Point-of-care testing
Article
January 2010
Blood oxygenation and spurious hypoxemia
One of the principal utilities of arterial blood gas
(ABG) analysis is to help assess blood oxygenation status. The two
ABG parameters used for this assessment are
pO2(a) (partial pressure of oxygen in arterial
blood) and sO2(a) (% of total hemoglobin that is
saturated with oxygen).
In health pO2(a) is
maintained...
Blood gases/acid-base
Point-of-care testing
Glucose
Hemoglobins
