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Articles by R. D. Feld
Showing articles by "R. D. Feld"
Article
October 2011
POC testing in the emergency department: Strategies to improve clinical and operational outcomes
Emergency departments (ED) are challenged by increasing patient visits, overcrowding and prolonged length of stay (LOS). The cause of these problems is multifactorial.
Delays in the laboratory are often perceived as contributing to delays in care and increased LOS. Implementation of selected point-of-care tests in...
D-dimer
Creatinine/urea
Natriuretic peptide
Troponins
Cardiac markers
Point-of-care testing
Process optimization
Article
September 2011
L-lactate and D-lactate - clinical significance of the difference
Modern blood gas analyzers often have incorporated sensor technology that allows measurement of plasma lactate concentration. In nature lactate exists in two isoforms: L-lactate and D-lactate.
In all vertebrates, including humans, the L-lactate form is by far the most abundant and pathophysiologically significant,...
Blood gases/acid-base
Glucose
Lactate
Kidneys/fluids
Article
July 2011
Central venous blood gas analysis
Blood gas analysis (BGA) is a laboratory and point-of-care test routinely used to assess acid-base status along with adequacy of ventilation and oxygenation among predominantly critically/acutely ill patients.
The ”gold standard” sample for BGA is arterial blood collected anaerobically by needle puncture of an artery ...
Blood gases/acid-base
Lactate
Hemoglobins
Article
July 2011
Assessment of plasma D-dimer as a diagnostic and prognostic aid for abdominal aortic aneurysm
Abdominal aortic aneurysms (AAAs) are currently identified by incidental imaging or ultrasound screening.
The potential diagnostic and prognostic value of D-dimer for AAA was assessed in this study. 1260 men from a population-based ultrasound screening study were included, of which 299 had small AAAs monitored by...
Coagulation/fibrinolysis
Creatinine/urea
D-dimer
CRP
Article
June 2011
How to manage sepsis in the Emergency Department leading to a decreased mortality in ICU - the Critical Care Cascade
Patients with sepsis, severe sepsis and/or septic shock are at increased risk of death and organ dysfunction.
While morbidity and mortality of patients with severe traumatic injury, acute myocardial infarction or stroke have been significantly reduced during recent years by the implementation of well-coordinated...
Infection/sepsis
Glucose
Point-of-care testing
Lactate
Hemoglobins
Article
April 2011
Optimizing accuracy and precision for point-of-care tests
Point-of-care testing sites continue to increase in number due to the availability of easy-to-use devices that make it possible to provide test results very quickly relative to the central laboratory services. There is, however, mixed review regarding the accuracy and reliability of POCT results for patient care. It...
Point-of-care testing
Preanalytical phase
Quality assurance
Glucose
Hemoglobins
Lactate
Troponins
Article
April 2011
Use of tri-sodium citrate in hemodialysis
Hemodialysis and related treatments for those with failing kidneys all involve blood flow through a circuit outside the body. This extracorporeal circuit - the dialysis machine and its connections from and back to the body - is a non-physiological, pro-coagulant environment.
To counter the tendency for patients'...
Point-of-care testing
Electrolytes
Blood gases/acid-base
Creatinine/urea
Kidneys/fluids
Article
January 2011
ROC curves – what are they and how are they used?
ROC curves are frequently used to show in a graphical way the connection/trade-off between clinical sensitivity and specificity for every possible cut-off for a test or a combination of tests. In addition the area under the ROC curve gives an idea about the benefit of using the test(s) in question.
ROC curves are...
Information management
Article
January 2011
Critical values in laboratory medicine
The process of patient sample testing, whether performed in the clinical laboratory or at the point of care, is the sum of three distinct phases. The first is the preanalytical phase, which includes test selection as well as sample collection and handling.
The second is the analytical or measuring phase that...
Bilirubin
Electrolytes
Point-of-care testing
Blood gases/acid-base
Glucose
Lactate
Creatinine/urea
Hemoglobins
Kidneys/fluids
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
