Abstract
Introduction: Arterial blood gas and serum lactate (ABG / SL) values have been shown to be markers for occult shock and poor outcome following blunt trauma. However, the utility of ABG / SL in blunt trauma patients who also receive computed tomographies (CT) of the chest, abdomen, and pelvis (CT C&A) remains unknown.Methods: A chart review was performed of all adult blunt trauma patients who received both CT C&A and ABG / SL upon presentation to our emergency department (ED) between January 1, 2007 and December 31, 2007. These patients (n=360) were identified from our institutional trauma registry database. Patients were divided into subgroups based upon whether they had a positive or negative ED evaluation for traumatic injury requiring hospitalization or immediate operative management. The expected course for patients with negative ED evaluations regardless of ABG / SL was discharge home. The primary outcome measure was the proportion of patients with a negative ED evaluation and an abnormal ABG or SL that were admitted to the hospital.Results: 2.9% of patients with a negative ED evaluation and abnormal ABG or SL were admitted. Of these, none were found to have any post-traumatic sequalae.Conclusion: We found that abnormal ABG / SL results do not change management or discharge disposition in patients without clinical or radiographic evidence of traumatic injury on CT C&A. Among patients who receive CT C&A, the routine measurement of arterial blood gas and lactate may be an unnecessary source of additional cost, patient discomfort, and delay in care.
Highlights
Arterial blood gas and serum lactate (ABG / SL) values have been shown to be markers for occult shock and poor outcome following blunt trauma
We found that abnormal ABG / SL results do not change management or discharge disposition in patients without clinical or radiographic evidence of traumatic injury on computed tomographies (CT) C&A
Among patients who receive CT C&A, the routine measurement of arterial blood gas and lactate may be an unnecessary source of additional cost, patient discomfort, and delay in care. [West J Emerg Med. 2013;14(3):212–217.]
Summary
Arterial blood gas and serum lactate (ABG / SL) values have been shown to be markers for occult shock and poor outcome following blunt trauma. The utility of ABG / SL in blunt trauma patients who receive computed tomographies (CT) of the chest, abdomen, and pelvis (CT C&A) remains unknown. Cross-sectional computed tomography (CT) of the chest, abdomen and pelvis (CT C&A) is obtained on many of these patients It remains unclear whether or not ABG / SL adds any predictive or prognostic value in the detection of clinically-significant occult injury when early CT C&A is obtained.
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