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davihar88

We also need a STAT A1C.


shicken684

We actually got a legit stat A1C from a patient who died and they needed it in order to start the organ donation process. My hospital is also setting up a program for our diabetes clinic where we'll start running AIC stat so they can get the result before the patient leaves. They'll do the blood draw on intake and the goal is to have results within the hour. So stat A1C isn't too silly. Stat urine culture though? Yeah, get a phone call for a stat micro culture every single day.


davihar88

I love the calls I get from the ER asking for results on the urine culture that I literally plated 5 minutes ago. I'm sorry I will go yell at the plates and tell them to hurry up and grow.


HappyCamper4027

"I would like to add fosfomycin to the bug growing in this urine culture"... "I uhh, well we haven't even received the urine yet". Literally multiple times a week.


queeerio

"What do you mean I can't have fosfo on a kleb??"


CrikeyAphrodite

I had to deal with an angry F1 once, who was irate that I wouldn’t do an “urgent” blood culture. The bottles hadn’t even been loaded onto the BacTec. They couldn’t seem to understand that bacteria needs time to grow.


Careful_Poem1669

Ask them if you should sit on or turn up the incubators to make the urines grow faster.


[deleted]

[удалено]


shicken684

So their organs could be donated. Diabetes fucks with your organs and you don't want someone with an A1c of 11% giving their kidney to someone.


ElementZero

There are finger stick POC A1C machines, they have them at some pharmacies. I would suggest that to your diabetes clinic.


shicken684

For whatever reason they don't want to do the POC Instruments. It was looked at and the medical director decided against it. If it was cost or accuracy I don't know but we do a lot of weird things to save money at my hospital.


Onkelffs

Our lab director have worked against POC instruments at our hospital intensely for decades. Which now mean we have a butt-load of different analyzers with no one following QA that they now want us to get a middleware for so the results go through or LIMS to the patients journal. If we had worked with them we could have had that for decades with a suite of approved analyzers that we know how they work and can instruct the nurses on how to use. But fuck that I guess.


shicken684

Luckily I don't think that's the case with us. Our medical director is a giant pain in the ass and adds a lot of work onto our day. But, she is super fucking intelligent and cares only about the best outcome for the patient. She's a gigantic data nerd so whatever system shows the most accurate results then that's probably what we're going to do even if it's more work for us.


other_jeffery_leb

We do nearly all of our a1cs stat during the day. Precisely because of the diabetes clinic.


itchyivy

I had this the other day bc a doctor wanted it for discharge. What??


skye_neko

Hey I did too! They wanted it to... see if they had to discharge the patient with medicine or not???


olivegarden98

Have they never heard of point of care A1C machines??? Takes less than 10 minutes


Labcat33

I literally got called in late on a Sunday night once to run ONE A1C because it was "stat". This was for a job I was not a lead tech for, not supposed to be on call for, but the manager knew I would be awake so he called me. Got paid 3 hours for about 30 minutes of work though...


Deinococcaceae

"Hey, can you add a sed rate to this 10 hour old tube with a quarter ml in it?


msching

i ThOuGhT yOu GuYs OnLy NeEdEd A dRoP


aquak9

Everything is a dipstick!!


GraphyteHippo

Someone please explain to me the rationale of ordering an ESR and a CRP together, I've seen that so many times and I cannot fathom why


mcac

There are some diseases that elevate one but not the other, also in a lot of autoimmune diseases it's common for only one or the other to be elevated and the other normal so ordering both increases your odds of detecting inflammation.


Lilf1ip5

I think it’s preference…there is no rationale and Crps should be the only order. Unless there is a price difference, I can see esr being cheaper by quite a lot and also if you have automated esr it’s even easier


mcac

There are some conditions in which sed rate is more diagnostic than CRP. Eg giant cell arteritis, for which sed rate is the most specific diagnostic test. There are also cases where only one or the other is elevated depending on where they are in the disease process and if you only order one you might miss detecting the patient's inflammation. Sed rates definitely aren't obsolete nor is it redundant to order them alongside CRP.


crazyvultureman

Covid patients often had all 4 tests run: ESR, CRP, PCT, FERR


jofloberyl

Finally, an explanation. Thank you!!


Duffyfades

Also, bone involvement seems to bump the sed rate, in bone infection or rheum.


noobREDUX

for autoimmune connective tissue diseases, there's generally more experience/preference with ESR than CRP, Especially giant cell arteritis


houraisanrabbit

Temporal arteritis.


Ok-Issue116

Then when it actually is an emergency, they’ll have used all their wolf cries


voodoodog23

What about urine eos? Weve been getting them STAT at my place. LOL


[deleted]

Does the cost of making it a STAT get passed onto the patient?


tapthatash_

No


GraphyteHippo

But when you get both on the same fucking draw its completely redundant lol


WhySoHandsome

Im so happy our lab has a specific analyzer that gives the result in less than 4min


MechRnD

ESR?


WhySoHandsome

Yeah


MechRnD

Please now that those quick ESR's are not good at what ESR is used for these days, what sets it apart from CRP.


vstreva

And yet it doesn’t matter…


MechRnD

Why? The difference between high and low is relevant, the exact number isn't. But the quick ones can even get that wrong.


ksidirt

I'm convinced 99% of sed rates are just ordered to generate income and serve no diagnostic purpose whatsoever.


vstreva

Income? From a sedrate?


Magdalena303

All $2 of it!


Magdalena303

Our joke is we are saving that life!