Laboruntersuchungen – was ist sinnvoll, was ist überflüssig?

Zusammenfassung

Laborparameter in der Notfallmedizin lassen sich drei Kategorien einteilen. An erster Stelle stehen die obligatorischen Parameter, die unmittelbare therapeutische Konsequenzen nach sich ziehen und innerhalb von 60 Minuten vorgehalten werden sollten. Für diese Parameter bietet sich die Bestimmung vor Ort als „Point-of-Care“-Testverfahren (POCT) an. An zweiter Stelle stehen die obligatorischen Parameter, die zwar nicht akut zur Abwendung einer Lebensgefahr notwendig sind, jedoch mittelbare diagnostische bzw. therapeutische Konsequenzen haben. Nach dem internationalen Konsens sollte die Aufenthaltsdauer von Patienten in der Notaufnahme 4 Stunden nicht überschreiten. Deshalb müssen entsprechende Parameter innerhalb dieses Zeitfensters verfügbar sein. Daneben gibt es Parameter, die keine dringenden diagnostischen bzw. therapeutischen Konsequenzen nach sich ziehen, die jedoch als Notfallparameter verfügbar sein sollten, um die Prozesse in der Notaufnahme und den Patientenfluss aufrechtzuerhalten. POC-Testverfahren sollten wenigen dringlichen Parametern vorbehalten sein und in Kooperation mit dem Zentrallabor als Satellitenlabor in der Notaufnahme organisiert werden.

Abstract

Laboratory parameters in emergency medicine can be divided into 3 categories. Urgent obligatory parameters are necessary for immediate therapeutic decisions and must be available within 60 minutes. For these, testing in the emergency department (ED) as point-of-care-testing (POCT) should be considered. The second category are obligatory parameters which require diagnostic / therapeutic consequences in the emergency department, but are not necessary for immediate life-saving actions. Due to international consensus of a 4-hour length of stay target for ED, results should be available within this time. The third category are parameters which do not lead to immediate diagnostic or therapeutic consequences, but are important for process management and patient flow in the ED. They should therefore be available as emergency tests. POC-testing should be used for a limited number of very urgent parameters and should be organized as a satellite laboratory in cooperation with the central laboratory.

Schlüsselwörter

Notaufnahme - Laborparameter - „Point-of-Care“-Testing (POCT) - Zentrallabor

Keywords

emergency department (ED) - laboratory parameter - point-of-care-testing (POCT) - central laboratory

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