D-dimer testing can combined with assessment of pretest probability be used to rule out VTE in patients with a sufficiently low pretest probability of VTE. Patients with a negative D-dimer result can be ruled out, while patients with a positive D-dimer result need to have imaging performed for confirmatory diagnosis. ...

In the past years, emergency rooms (ER) all over Germany, especially those of maximum-care hospitals, have been faced with an increasing number of patients. This is caused by a variety of factors, including demographic changes, inflexible ambulant services and an overreaching demand for healthcare services. ER...

The management at the emergency department of patients presenting with symptoms of chest pain and/or acute dyspnea accounts for a substantial proportion of emergency care resources. In the work-up of these patients the blood measurements of cardiac troponins and brain natriuretic peptides are recommended by current...

Point-of-care testing (POCT) for key laboratory variables may help clinicians assess the level of acuteness and the level of care necessary in the management of deteriorating ward patients. We used a multibiomarker POCT panel including B-type natriuretic peptide (BNP), D-dimer, myoglobin (Myo), creatine kinase MB...

With increasing age, an unspecific rise of fibrin degradation product in blood is observed. Thus, the D-dimer test to rule out thromboembolic events has a high false positive rate in elderly patients. In 2010, Douma et al introduced a formula to adjust D-dimer cut-off values for age in outpatients >50 years: Age ×...

D-dimers are protein products of cross-linked fibrin degradation that are present in the blood of most healthy individuals in only negligible amounts (of the order 100-200 ng/mL). As objective evidence of increased fibrinolysis, elevated blood concentration of D-dimer is by extension evidence of intravascular...

How do errors occur in the laboratory and what can we do to prevent errors? Any test can and will fail if incorrectly performed or operated under the wrong conditions. The role of the laboratory director is to determine those conditions and to understand test limitations in order to prevent laboratory errors....

In a regional top-management decision, our laboratory was given the mission to control and quality assure all POCT activities in a regional network of 10 hospitals with emergency units. Based on previous work, new region-wide recommendations, procurements,  IT connectivity, services, training, accreditation (ISO...

Emergency Department (ED) overcrowding is becoming an increasingly international issue.  Although the problem is not only resolved by ED change management (but rather requires a system-wide solution recognizing the complex interdependencies of consumer expectations, human resources, information systems immaturity and...

Point of care (POC) testing has become an important part of nephrological care. In cases of acute renal failure, POC is indispensable in deciding the need for dialysis, but is also essential in the management of patients on regular dialysis. For example, hyperhydration, cardiovascular adverse events and inflammation...