Impact of emergency room laboratory studies on the ultimate triage and disposition of the injured child.
One hundred sixty six surviving pediatric trauma patients were retrospectively studied to assess the contribution of initial laboratory evaluations to clinical decision making in the emergency department (ED). All laboratory tests ordered, the results of those tests and the number of test results available before patient disposition from the ED were reviewed. A total of 626 laboratory studies were ordered in 166 patients. Results from only 68.5 per cent of the laboratory tests were available in the ED prior to the patient's transfer from the ED. Only 6.4 per cent of these results were abnormal. This low incidence of abnormal test results and preadmission availability questions the utility of extensive initial routine laboratory evaluations of the pediatric trauma patient. Based on this data, the current protocol has been revised to include hemoglobin/hematocrit determinations, type and screen, and urinalysis. Additional blood is obtained and appropriately labeled so that further studies can be performed if the patient's management should require baseline laboratory evaluations. This approach is more efficient, cost-effective, and no less sensitive in the initial evaluation and management of the injured child.
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D003955:Diagnostic Tests, Routine / Q000191:economics*; D004632:Emergency Medical Services; D004636:Emergency Service, Hospital / Q000191:economics*; D005431:Florida; D006745:Hospital Bed Capacity, 300 to 499; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014218:Triage; D014947:Wounds and Injuries / Q000175:diagnosis*