what do these numbers stand for?

[JanMayen]

Hey, do anyone know the meanings these numbers stand for in the pic (the upper half) ? The format of writing lab test results is not familiar to me. Thanks.

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[HomeSkool]

The left one is a CBC. WBC 11.94, hemoglobin 14.5, hematocrit 42.6, platelets 382.

The middle one is a BMP. Na 142, K 3.7, Cl 104, CO2 17, BUN 9, creatinine 0.9, glucose 106.

The right one is LFTs, but in an order I haven't seen before. I'm guessing it's total protein 6.9, albumin 3.5, total bilirubin 0.8, direct bilirubin <0.2, AST 29, ALT 77, alk phos 116.

 

[JanMayen]

The left one is a CBC. WBC 11.94, hemoglobin 14.5, hematocrit 42.6, platelets 382.

The middle one is a BMP. Na 142, K 3.7, Cl 104, CO2 17, BUN 9, creatinine 0.9, glucose 106.

The right one is LFTs, but in an order I haven't seen before. I'm guessing it's total protein 6.9, albumin 3.5, total bilirubin 0.8, direct bilirubin <0.2, AST 29, ALT 77, alk phos 116.

thanks

 

[Peach Newport]

Should I be worried that as an oms2 I’ve never seen anything that looks like these pictures?

 

[mw18]

Should I be worried that as an oms2 I’ve never seen anything that looks like these pictures?

No, it's a pretty clinical thing so it makes sense if you haven't come across it. But as you get to the wards it's a pretty easy and valuable thing to learn. So if you're getting numbers for your surgery team or whatever you can write them quickly in a standardized fashion.

Edit: Probably only the CBC and the Chemistry fishbone. The LFT one is new to me, so loses utility in that it's not as standardized.

 

[prettyNURSEtoMD]

I agree, the LFT looks weird, assuming that’s what it is. I’m used to seeing it horizontal. There’s also PT/PTT/ INR, and a Ca/Mg/Po4, ABG, etc etc. Once you get used to the lab values and seeing it over and over it’ll be second nature. I’ve worked with physicians who each do a different method.

 

[Goro]

Should I be worried that as an oms2 I’ve never seen anything that looks like these pictures?

At my school, when we give lab results, they are nothing like what's in the OP!

 

[username456789]

At my school, when we give lab results, they are nothing like what's in the OP!

They (fish bones) are used every day on the wards.

 

[libertyyne]

They (fish bones) are used every day on the wards.

Do attendings make the residents or medical students fill out those loose sheets they carry around with these on them?

 

[libertyyne]

could anyone explain why they are organized the way they are?

 

[username456789]

Do attendings make the residents or medical students fill out those loose sheets they carry around with these on them?

That wasn’t my experience and I’m not sure what loose sheets you’re talking about, although it’s possible they do it for students for educational purposes. But in general, anytime a note is written that is how labs are documented. I’m sure there are some exceptions.

 

[username456789]

could anyone explain why they are organized the way they are?

Because, in general, that’s how different panels are organized. BMP vs CMP vs LFTs vs CBC, and so on.

From left to right in the OP, that’s a CBC, a BMP, and an LFT (CMP = BMP + LFT, more or less).

 

[libertyyne]

That wasn’t my experience and I’m not sure what loose sheets you’re talking about, although it’s possible they do it for students for educational purposes. But in general, anytime a note is written that is how labs are documented. I’m sure there are some exceptions.

I dont think they were organized in our EMR like this, so the attendings/ residents would walk around with preprinted sheets like this when they were rounding with the numbers hand filled in.

 

[libertyyne]

Because, in general, that’s how different panels are organized. BMP vs CMP vs LFTs vs CBC, and so on.

From left to right in the OP, that’s a CBC, a BMP, and an LFT (CMP = BMP + LFT, more or less).

Thanks, I meant interms of where the Hemoglobin is written in vs WBC etc. I wasnt sure if there was a rational reason or other reason to have them organized in that fashion.

 

[username456789]

I dont think they were organized in our EMR like this, so the attendings/ residents would walk around with preprinted sheets like this when they were rounding with the numbers hand filled in.

I’m from the ancient past of about 10 years ago where all daily progress notes were hand written (for students, at least), so you copied them down from the lab result tab of the patient’s EMR onto a blank piece of paper when you got to the “O” of your SOAP note. But we didn’t need any pre printed sheets. They’re not difficult to draw out as you go.

 

[longhaul3]

Obviously they are not familiar to everyone, but in my experience these formats are indeed widely utilized.

 

[Cognovi]

There is little agreement across institutions on the organization of the LFT fishbone.

 

[kavorca]

CBC fishbone makes some sense as Hb/Hct. Same with the BMP, Na and Cl together and Bun/Cr