EHC ED Critical Care
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LactateYou may see many of the residents ordering lactates on patients with infections. Ideally, we will perform a lactate on every potentially septic patient and on every patient from whom we are drawing blood cultures. Lactate provides an early screen to the patients who are really sick, but do not show external signs yet.
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You'll need a green top or the syringe and cap from an abg kit. If a superstat II was ordered as well, grab the green. If a superstat I or a vbg was ordered as well, grab the abg syringe. If only the lactate was ordered, grab either. |
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You'll also need a bag of ice; it's best to get it before you start to draw blood. If the tube for the lactate is not kept cool, the value will falsely rise. It is also very important that the lactate is the first or amongst the first tube drawn. If the tourniquet has been on for a while (like when we have to draw 5 or 6 tubes) the value can be falsely high. Draw the lactate tube and then immediately put it on ice, then draw the rest of the bloods. |
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If you are drawing with the abg syringe, you may still use the vacutainer. Just push the tip of the syringe into the gray cover and pull back on the syringe. |
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I demonstrate that here without the vacutainer hub just to make it easier to see. NEVER draw blood in this manner; always use the vacutainer hub. |
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After filling the abg syringe, place on the cap. This cap lets you push all of the air out of the syringe without blood coming out as long as the cap faces the ceiling. Get out all the air from the syringe. |
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If you are sending a lactate and a vbg/superstat, two labels will print out. If you only place one of these labels on the syringe and place the other in the bag, the lab folks will only run one. |
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Place both labels on horizontally and then stick them to the sheets containing the extra labels for the two tests. |
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Place all of that on ice. |
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In summary:
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