Notations and Normative Values in Human Lab Values

Previously, I had posted on my thoughts on lab values and its integration in clinical PT practice. There are subtle issues within this. In non-electronic formats, i.e. paper charts, labs are commonly denoted in shorthand that the residents are trained to use and read, as second nature. Unfortunately most PT students and even mature clinicians do not find it easy to read notations, less interpret it. While there is a plethora of web references in lab values, there is surprisingly, a lack of easily found reference to notation style, even on a Google search. The purpose of this post is therefore to provide a handy reference to lab value notations and normative values of common work up.



Common Lab Tests Reference Range for Adults -

1. http://web.missouri.edu/~proste/lab/

2. http://www.bloodbook.com/ranges.html#BLOOD

Here is to more astute PT practice....

Cheers,

Acute PT

Consults vs. Orders

A few weeks of break and my apologies. Took the family through the Big Apple and the DC area. In the meantime, some interesting posts on the Acute Care listserv, and a big win for healthcare in Congress. You must have heard of the news on HR 6331 - the Medicare Improvements for Patients and Providers Act. Or you can read all abou it here: Congress Overrides Presidential Veto. But this post is about a pet peeve of mine: Consults or Orders: what is the right wording?

There is this talk in acute care circles; of a paradigm shift in physical therapy practice. How physician referrals are to be worded: Consults vs. Orders, is a matter of indignation among therapists. There are those who are proponents for Consults - a new conceptual framework, that allows the rightful allocation of respect for the expertise, opinion, and overall collegiality among parallel medical professionals. Then those who are detractors. Really. These group of individuals cherish being "told" what, how, when, and those tiny other details, that has long been the "way" to do things in the PT world. Finally, there is what I like to think of the existential group. These group of professionals are just glad to exist. They do not really care what the wording are, as long as they have met their 9-5 commitment. And the next paycheck is in the bank.

One recent post on the acute care list serv stated, how they have been attempting to change this mindset of being "ordered". How referrals to our specialty need to, and should be worded as "consults". I cannot agree more. PT is a specialty practice. In any setting. In the acute care, we are just another consulting service. We do not exist to lift, or move, or kowtow to nursing. No our role is to evaluate and interpret movement dysfunction, and fix the cause. We need to advice, and, as needed intervene in manners appropriate to the physio-pathological state of a condition, in a manner that can be backed by evidence in literature.

We need to educate physicians along these lines. And in my experience, one has to just use rational knowledge of pathophysiology to get the attention of these physicians. Why we need not have to lift to provide appropriate care. It is not an easy task, but to achieve this goal, we will have to rid ourselves of our own internal inertia, and bring our own dissident kind to the same table from where the think-tank are speaking. Until we get this unity, we are only giving adage to the "divided, we fail".

Until next time....

AcutePT