scholarly journals Total Calcium and Ionized Calcium (pH = 7.4) Tests Are Equal When Screening Patients for Hypercalcemia at Admission in the Emergency Department: A Retrospective Descriptive Study

2021 ◽  
Vol 11 (5) ◽  
pp. 108-114
Author(s):  
Regitze Wittenberg ◽  
Trine Rennebod Larsen ◽  
Lis Stilgren ◽  
Steen Antonsen
PEDIATRICS ◽  
1985 ◽  
Vol 76 (4) ◽  
pp. 543-550
Author(s):  
Pankaja S. Venkataraman ◽  
Don A. Wilson ◽  
Roger E. Sheldon ◽  
Radhakrishna Rao ◽  
Michael K. Parker

Traditionally, in infants, a serum calcium value less than 7.0 mg/dL is considered to impair cardiac function. In very-low-birth-weight infants, we studied the hypotheses that decline in serum calcium to 6.0 mg/dL (1) would not impair cardiac function and (2) ionized calcium would remain greater than 3.0 mg/dL. We also evaluated the effect of calcium infusion on cardiac function. We studied 15 normokalemic and normonatremic infants whose birth weights were 822 to 1,450 g and were less than 32 weeks' gestation. When serum calcium declined to less than 6.0 mg/dL, 18 mg/kg of calcium as 5% calcium gluconate was infused for 10 minutes. Serum total calcium concentration, blood ionized calcium concentration, ECG, and M-mode echocardiogram were obtained on entry into the study, when the infants were hypocalcemic, immediately after treatment with calcium, and eight hours after treatment. Ionized calcium values were calculated based on serum total calcium and serum protein, and corrected calcium values were calculated based on serum total calcium, serum albumin, and blood pH. In all infants, serum calcium value declined to less than 7.0 and in eight infants to less than 6.0 mg/dL. Assessment of heart rate, systolic blood pressure, ejection fraction, left ventricular systolic time interval, right ventricular systolic time interval, fiber shortening index, and left ventricular mean velocity of circumferential fiber shortening showed no significant alteration from baseline during hypocalcemia or in association with intravenous slow bolus infusion of 18 mg/kg of calcium. In association with a decline in serum total calcium to as low as 6.0 mg/dL, whole blood ionized calcium was maintained at more than 3.0 mg/dL. Serum total calcium and calculated ionized calcium values correlated significantly with measured blood ionized calcium concentrations; however, these measures were not reliable predictors of blood ionized calcium. We speculate that the hypoproteinemia and hypoalbuminemia noted in these infants may result in relative protection of the blood ionized calcium in these infants. We suggest that in neonates with wide ranges in gestation, serum protein, and blood pH levels, total serum calcium and calculated ionized calcium values may be poor measures of derangement of calcium metabolism. Decline in total serum calcium concentration to 6.0 mg/dL was not associated with impaired cardiac function, and slow bolus calcium infusion in these hypocalcemic very-low-birth-weight infants neither improved nor impaired cardiac function.


PEDIATRICS ◽  
1972 ◽  
Vol 49 (6) ◽  
pp. 841-846
Author(s):  
David M. Brown ◽  
James Boen ◽  
Audrey Bernstein

Relationships of serum ionized calcium with several biochemical parameters have been examined in newborn infants under 72 hours of age. Hypocalcemia was defined as plasma total calcium below 7.5 mg/100 ml. There was a linear correlation between plasma total calcium and ionized calcium in the entire group. Other positive correlations included: (1) plasma total calcium and serum total protein, albumin, and globulins and (2) absolute concentrations of ionic calcium and albumin. No statistically significant correlations were observed between either total or ionized calcium and serum phosphorus, percent ionized calcium, capillary pH, or Pco2. The derived values for serum ionic calcium from the McLean-Hastings nomogram did not correlate with the plasma ionic calcium as determined by the ion-specific electrode and may not be used in newborn infants to predict accurately the level of plasma ionic calcium.


2005 ◽  
Vol 12 (4) ◽  
pp. 219-222 ◽  
Author(s):  
Pascale Gervais ◽  
Isabelle Larouche ◽  
Lucie Blais ◽  
Anne Fillion ◽  
Marie-France Beauchesne

BACKGROUND: The management of asthma remains suboptimal despite the publication of Canadian asthma guidelines in 1999.OBJECTIVES AND METHODS: A descriptive study was conducted to estimate the proportion of patients admitted to the emergency department (ED) for an asthma exacerbation who received a management plan at discharge that was in accordance with seven criteria stated in the Canadian asthma guidelines. The present study took place in two tertiary care hospitals in Montreal, Quebec.RESULTS: A total of 37 patients were enrolled. Three (8%) patients received a management plan at discharge that was in accordance with all seven criteria. Inhaled corticosteroids and oral corticosteroids were prescribed at discharge for 29 (78%) and 35 (95%) patients, respectively. Minimal asthma education was provided for 29 (78%) patients and a medical follow-up was recommended to 22 (60%) patients. Airflow obstruction was evaluated at discharge for only 20 (54%) patients.CONCLUSION: Overall, asthma management at discharge from the ED was generally not in accordance with the 1999 Canadian asthma guidelines. A standardized management plan should be implemented in the ED to improve the care of patients with asthma exacerbations.


2013 ◽  
Vol 33 (12) ◽  
pp. 1471-1477 ◽  
Author(s):  
Lorena Alvariza Amaral ◽  
Millie Marchiori ◽  
Charles Ferreira Martins ◽  
Marcio Nunes Correa ◽  
Carlos Eduardo Wayne Nogueira

The Crioulo breed of horses performs in one of the most physically demanding equestrian competitions, the Marcha de Resistência, which is a contest in which the horses run 750 km in 15 days. The study's aim was to characterize the metabolic responses during this period. We evaluated eleven Crioulo horses in the competition, specifically, two males and nine females. Blood samples were collected 24 hours before the contest and on the 4th, 9th, 11th, 14th and 15th days of competition. We evaluated CK, AST, LDH, glucose, lactate, urea, creatinine, sodium, potassium, chloride, magnesium, total calcium, ionized calcium, total protein, hematocrit and the white blood cell count. At the end of the competition, the mean values of serum AST were 1151±358 IU/ L the mean LDH values were 7418±1695 IU/L and CK was 13,867±3998UI /L. There was a significant increase in urea, creatinine and lactate (p<0.0001). A decrease in the mean values of chloride, sodium, potassium, and total and ionized calcium was observed (p≤0.0002). An evaluation of the total leukocytes and segmented neutrophils (p≤0.0002) revealed their increased values, and decreased values were observed for hematocrit, plasma protein and total lymphocytes (p≤0.0003). The values of glucose, on average, remained constant. Based on these data, we conclude that the Marcha de Resistência competition necessitated a high muscular demand and the depletion of energy and electrolytes, suggesting an inflammatory process in the animals evaluated.


e-CliniC ◽  
2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Muhammad F. Bazmul ◽  
Eka Y. Lantang ◽  
Barry I. Kambey

Abstract: Emergency Department provides first emergency services to patients with threats of death and disability in an integrated manner involving multi disciplines. Patients who come to the Emergency Department are always assessed as 3 priorities, namely priorities 1, 2 and 3. Priority 1 is case/disease with life-threatening emergency or severe emergency; Priority 2 is case/disease with mild emergency; and Priority 3 is non-emergency case/disease. This study was aimed to obtain the Triage profile of patients at Emergency Department of Prof. Dr. R. D. Kandou Hospital Manado. This was a retrospective descriptive study using patients’ medical records. Samples were all patients treated at the Emergency Department of Prof. Dr. R. D. Kandou Hospital from January 2018 until July 2018. The results showed that there were 19,229 patients as samples. Based on sex, most patients were male, meanwhile based on age most were 51-70 years, with the highest number of patients in March 2018. There were 6,913 patients (35.9%) in the orange or emergency category (Priority 2) and 6,130 patients (31.8%) in the yellow category (Priority 3). Conclusion: Based on the Start Triage in Emergency Department, the majority of patients were in Priority 2 category, followed by Priority 3 category.Keywords: Emergency Department, Start Triage Abstrak: Instalasi Gawat Darurat (IGD) memberikan pelayanan pertama yang bersifat emergency pada pasien dengan ancaman kematian dan kecacatan secara terpadu dengan melibatkan multi disiplin ilmu. Pasien yang datang di IGD selalu dinilai kegawatannya menja-di 3 prioritas, yaitu prioritas 1, 2, dan 3. Prioritas 1 yaitu kasus/penyakit dengan kegawat-daruratan yang mengancam jiwa atau gawat darurat berat. Prioritas 2 untuk kasus/penyakit dengan gawat darurat ringan. Prioritas 3 untuk kasus/penyakit yang bukan gawat darurat. Penelitian ini bertujuan untuk mengetahui profil skala Triase pasien yang masuk di IGD RSUP Prof. Dr. R. D. Kandou Manado. Jenis penelitian ialah deskriptif-retrospektif, menggunakan data rekam medis pasien. Sampel penelitian ialah seluruh pasien yang dirawat di IGD RSUP Prof. Dr. R. D. Kandou Manado periode Januari 2018 sampai Juli 2018. Hasil penelitian mendapatkan data pasien yang masuk ke Ruang IGD RSUP Prof. Dr. R. D. Kandou Manado terhitung sejak Januari hingga Juli 2018 sebanyak 19.229 orang. Distribusi pasien terbanyak berdasarkan jenis kelamin ialah laki-laki, dan berdasarkan usia ialah 51-70 tahun, dengan jumlah pasien terbanyak pada bulan Maret 2018. Pasien IGD terbanyak ialah kategori jingga yaitu emergency (Prioritas 2) berjumlah 6.913 orang (35,9%) serta kategori kuning (Prioritas 3) berjumlah 6.130 orang (31,8%). Simpulan: Berdasarkan skala Triase di IGD, pasien terbanyak ialah Prioritas 2, disusul dengan Prioritas 3.Kata kunci : Instalasi Gawat Darurat, skala Triase


1990 ◽  
Vol 3 (3) ◽  
pp. 237-239
Author(s):  
Yutaka Takata ◽  
Yoshiaki Yamashita ◽  
Shuichi Takishita ◽  
Masatoshi Fujishima

Sign in / Sign up

Export Citation Format

Share Document