title: Abnormal arterial blood gas and serum lactate levels do not alter disposition in adult blunt trauma patients after early computed tomography.
abstract: BACKGROUND
  Arterial blood gas and serum lactate (ABG / SL) values have been shown to be markers for occult shock and poor outcome following blunt trauma. However, the utility of ABG / SL in blunt trauma patients who also receive computed tomographies (CT) of the chest, abdomen, and pelvis (CT C&A) remains unknown.
  
  
  METHODS
  A chart review was performed of all adult blunt trauma patients who received both CT C&A and ABG / SL upon presentation to our emergency department (ED) between January 1, 2007 and December 31, 2007. These patients (n=360) were identified from our institutional trauma registry database. Patients were divided into subgroups based upon whether they had a positive or negative ED evaluation for traumatic injury requiring hospitalization or immediate operative management. The expected course for patients with negative ED evaluations regardless of ABG / SL was discharge home. The primary outcome measure was the proportion of patients with a negative ED evaluation and an abnormal ABG or SL that were admitted to the hospital.
  
  
  RESULTS
  2.9% of patients with a negative ED evaluation and abnormal ABG or SL were admitted. Of these, none were found to have any post-traumatic sequalae.
  
  
  CONCLUSIONS
  We found that abnormal ABG / SL results do not change management or discharge disposition in patients without clinical or radiographic evidence of traumatic injury on CT C&A. Among patients who receive CT C&A, the routine measurement of arterial blood gas and lactate may be an unnecessary source of additional cost, patient discomfort, and delay in care.
authors.affiliation: Henry Ford Hospital, Department of Emergency Medicine, Detroit, Michigan.
authors.forename: Taher
authors.initials: T
authors.lastname: Vohra
authors.forename: James
authors.initials: J
authors.lastname: Paxton