Lab Values

Course overview

Objectives List common lab values Describe how to treat and manage various abnormal lab values Content Why Learn Lab Values 1 Reasons Against We do not draw labs It will not change our treatment We treat signs and symptoms not numbers How often have you walked into a facility for an interfacility transport and they list labs that mean nothing to you knowing you will not use them for your ten minute transport I used to nod and smile then take the patient Most of the time they were stable and I could treat any symptom they had 2 Reasons For EMS is changing toward performing labs Already performing blood glucose Prehospital lab draws for trauma stroke and CVA patients With Medicare and Medicaid holding back reimbursements for unwarranted transports and emergency department visits we are seeing growth in community health paramedicine Highly important for interfacility transports especially long ones Better integration and collaboration of EMS with hospitals and clinics Boosts the image of EMS as a medical profession Most important reason It makes you a better provider Understanding lab values helps medics think like detectives and better understand patient conditions 3 What We Will Cover Basic lab values Their significance Key tips to guide patient care 4 What We Will Not Cover Every lab and application This is a basic overview to encourage further learning Encouragement to look up lab values encountered in the field Blood 1 Composition Blood consists of plasma fifty five percent and blood cells forty five percent 2 Plasma Seven percent protein Ninety one percent water Two percent other solutes Protein Components Albumin fifty eight percent maintains oncotic pressure and keeps fluid in the circulatory system Globulin thirty eight percent transports substances and supports immune function Fibrinogen four percent essential for clot formation Other Solutes Ions nutrients waste products gases and regulatory substances 3 Blood Cells Serum is plasma without clotting factors Red Blood Cells Transport oxygen and carbon dioxide Contain hemoglobin which binds oxygen and carbon dioxide White Blood Cells Function in infection and immune response Neutrophils fifty to seventy percent Primary phagocytic cells Mature cells are segmented neutrophils Immature cells are bands or stabs Increased bands greater than ten percent suggest infection and sepsis Lymphocytes twenty to forty percent High levels suggest viral infection Low levels associated with infection Monocytes four to eight percent Eosinophils zero to four percent Basophils zero to two percent Platelets Function in coagulation Issues include too many too few or altered function Complete Blood Count Red Blood Cells Male four point three to five point seven trillion cells per liter Female three point nine to five point zero trillion cells per liter White Blood Cells Three point five to ten point five billion cells per liter SIRS criteria white blood cells less than or equal to four or greater than or equal to fourteen High or low values suggest infection Very high values may indicate leukemia Low values may indicate bone marrow depression chronic illness or leukemia White Blood Cell Differential Neutrophils two point zero to seven point zero times ten to the ninth per liter forty to eighty percent Lymphocytes one point zero to three point zero times ten to the ninth per liter twenty to forty percent Monocytes zero point two to one point zero times ten to the ninth per liter two to ten percent Eosinophils zero point zero two to zero point five times ten to the ninth per liter one to six percent Basophils zero point zero two to zero point one times ten to the ninth per liter less than two percent Absolute values are more useful than percentages Hemoglobin Male thirteen point five to seventeen point five grams per deciliter Female twelve point zero to fifteen point five grams per deciliter Hematocrit Male thirty nine to fifty percent Female thirty five to forty five p