The notion that orange juice may be harmful to health seems counterintuitive if not bizarre, but as a recently published case history reveals, orange juice contains significant amounts of potassium and ingestion of large quantities of orange juice can lead to hyperkalemia of sufficient severity to threaten life.  Over ...

Intensive intravenous insulin therapy directed at maintaining blood glucose concentration within tight normal limits (4.4–6.1 mmol/L) is now a standard of care for the critically ill. This requires frequent point of care blood glucose testing.   For appropriate intravenous insulin dosing it is vital that the chosen...

The ‘gold standard’ sample for blood gas analysis is arterial blood obtained via an indwelling arterial catheter or by arterial puncture. For a number of reasons capillary blood is an attractive substitute sample that is routinely used in some clinical settings.  The purpose of this article is to examine the evidence ...

It is estimated that a majority of all laboratory medicine errors are errors that occur during the preanalytical phase of the laboratory testing cycle. Such errors have a significant impact on patient safety, staff workload, and hospital costs.  Correctly identifying patients and avoiding specimen-labeling errors are...

With the use of a new Data Management System (DMS) software program [1], the majority of Point Of Care Testing (POCT) equipment throughout the Waikato District Health Board region has been connected to the Laboratory Information System (LIS) and the Hospital Information System (HIS). Prior to the new DMS, viewing...

Introduction of point–of-care testing (POCT) in hospitals requires the use of principles of change management. Manufacturers can support this process. E-learning programs adapted to the local situation with regular updates, a centralized accreditation and user-registration system and service level agreements are...

Maintaining lasting progress in laboratory test utilization is difficult to do without a reminder tool for providers. Since implementation of a quarterly physician report card in 2003, we have seen sustained improvement in the ordering of wellness tests in an ambulatory care network in the United States for over four...

There are few medical diagnoses that depend solely on the result of a single blood test, but diabetes mellitus, which is defined by concentration of circulating glucose, is one that does. Quite apart from its long established role in diagnosis as well as life-long monitoring of diabetes, measurement of circulating...

The integrity and function of all cells depend on an adequate supply of oxygen. Severe acute illness is frequently associated with inadequate tissue perfusion and/or reduced amount of oxygen in blood (hypoxemia) leading to tissue hypoxia.  If not reversed, tissue hypoxia can rapidly progress to multiorgan failure and ...

Part 2: Red flags The transition from fetus to newborn is a process of rapid physiological adaptation that is sometimes delayed by complications. Most newborns complete the process of transition with little or no delay.  These infants may demonstrate normal transitional findings, including tachypnea and tachycardia, ...