In Emergency Cases I

DR. Med. Dr. Untung Widodo, SpAn.KIC.

Dept. Of Anesthesiology & Reanimation
Faculty of Medicine, Gadjah Mada University
Yogyakarta, 2016
I. Introduction
Lab. Exam : lab procedures for :
- diagnostic
- monitoring
- evaluation
Should be strong medical indicated
The indication , may be findings in :
anamnesis
physical examination
laboratoric findings before
Should have DD (Differential Diagnosis)
II. Laboratoric measure in
emergency cases
Goals :
- diagnosis for live capacity:
Oxygen carrying capacity : Hb, Hmt,
Screening of inflammatoric response : AL, difftel
Physiologic coagulation : AT, CT, BT, PTT, aPTT
- diagnosis of systemic perfussion : BGA, Lactate
III. Specific measurement
To evaluate suspected bleeding process eg. internal
bleeding etc. : Serial Hb
To evaluate the resuscitation of Shock : clinical monitoring
and serial BGAs
To Guide of Continuous iv. Insulin Treatment : serial
/periodic Blood glucose concentrations
In unconscious patients should be measured blood
glucose
To evaluate the plasma leakage from blood vessel of
Dengue Hemorrhagic Fever : serial/periodic Hmt
For specific suspected diagnosis, HbsAg. HIV, Leptospira,
etc.
IV. Imaging examination
X-ray /USG/ MRI :
Head Trauma : Head x-ray, CT =scan
Chest x-ray ( Lung and Costae, thoraxic space)
Abdominal ( 3 positions – for suspected Ileus, GIT
perforation )
Bones ( vertebrae or extremities )
USG :
Abdominal trauma
Pelvic trauma, etc.
IV. Specific imaging
X-ray
to guide any procedure with bones reposition etc.
to evaluate catheter placement, etc.

USG
to guide any procedure , for example CVC insertion,
etc.
V. Conclussions
Measurement should have strong medical Indication

To support : diagnosis, monitoring, evaluation or

guide a treatment, but don’t to make delay any
treatment

To support effectiveness of patients managements

Alhamdulillahi Robbil’alamiin