biochimica clinica

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DOCUMENTI - Documents

Volume:

Biochimica Clinica 2018; 42(4) 335-342

Pubblicato on-line:

Settembre 4, 2018

DOI:

10.19186/BC_2018.050

Scarica in PDF:
Autenticazione richiesta

Medicina di laboratorio e Medicina d’urgenza: un connubio indissolubile

AUTORI

Giuseppe Lippi1, Fiamma Balboni2, Laura Bonfanti3, Paolo Carraro4, Mario Cavazza5, Daniele Coen6, Giorgio Da Rin7, Roberto Lerza8, Carmelo Madia9, Martina Montagnana1, Ciro Paolillo10, Giulia Sancesario11, Lorenza Zardo12, Gianfranco Cervellin3
1Sezione di Biochimica Clinica, Università degli Studi di Verona
2Laboratorio Analisi, Istituto Fiorentino Cura e Assistenza IFCA, Firenze
3Unità Operativa Complessa di Pronto Soccorso e Medicina d’Urgenza, Dipartimento Provinciale Interaziendale EmergenzaUrgenza, Azienda Ospedaliero-Universitaria di Parma
4Medicina di Laboratorio, Ospedale dell’Angelo, Azienda ULSS 3 Serenissima, Mestre, Venezia
5Medicina d’Urgenza e Pronto Soccorso-Dipartimento dell’Emergenza-Urgenza, Azienda Ospedaliero-Universitaria di Bologna
6Grande Ospedale Metropolitano Niguarda, Milano
7Medicina di Laboratorio, AULSS 7 Pedemontana, Bassano del Grappa, Vicenza
8Struttura Complessa di Pronto Soccorso e Medicina d’urgenza Ospedale San Paolo, Savona
9Medicina D'Urgenza e Pronto Soccorso, Ospedale Ca' Foncello, ULSS 2 Marca Trevigiana, Treviso
10Pronto Soccorso, Spedali Civili di Brescia
11Dipartimento di Medicina Sperimentale e Chirurgia, Università di Roma Tor Vergata e Dipartimento di Neurologia Clinica e Comportamentale, IRCCS Fondazione Santa Lucia, Roma
12Laboratorio Analisi, Ospedale S. Giacomo di Castelfranco V.to (TV), ULSS 2 Marca Trevigiana, Castelfranco V.to, Treviso

ABSTRACT

Laboratory Medicine and Emergency Medicine: an essential partnership

Laboratory Medicine and Emergency Medicine: an essential partnership. A better understanding of the pathophysiological bases of many pathologies, along with the considerable technological advances occurred over last few years, have allowed to broaden number and complexity of in vitro diagnostic tests. The emergency department is the clinical setting with the highest risk of forensic disputes, and this explains the inclination that many emergency physicians have towards defensive medicine. Disproportionate request of laboratory tests, with poor awareness on the impact of inappropriateness, is one of the leading negative aftermath of this attitude. The predictable consequences are economic, but also encompass the risk of generating direct damage to the patients, especially in the presence of false positive test results. Since diagnostic appropriateness represents an essential element for patient safety and for sustainability of the National Healthcare System, the Italian Society of Clinical Biochemistry and Clinical Molecular Biology (SIBioC) and the Academy of Emergency Medicine and Care (AcEMC) have organized a joint meeting entitled “Laboratory Medicine and Emergency Medicine: an essential partnership”, of which this document is a summary. The issues that have been discussed represent major diagnostic dilemmas faced by emergency physicians, and for which the contribution of laboratory medicine may be decisive. These include acute systemic infections, acute abdominal pain, acute chest pain, head injury and acute bleeding. Since timely transmission of test results is an additional critical element for the clinical decision making in emergency settings, the document will also include considerations on sample transportation from the emergency room to the laboratory.

BIBLIOGRAFIA