Have not kept up with this thread from the start, but it just caught my eye.
If I understand it, to summarise, the question was whether certain parameters which are not affected by the fault in the blood sample should or should not be reported (obviously, there would still be an evident indication that the sample was faulty and hence the other results are NOT reported). Can we rely on ANY test done on a faulty sample if we know that this particular test is not affected.
Well, you cannot rely on a potassium reading from a haemolysed sample, but you can still cross-match it for transfusion...
You cannot culture a non "clean catch" urine specimen, but if you dip it for blood and get a negative, would you need to ignore that?
From: [log in to unmask]> You wouldn't ask a Radiologist to try to rule in or rule out pneumonia on a chest Xray of poor quality.
--> Agree 100%. This would be the equivalent of getting a potassium reading from a clotted sample.
BUT what if your radiologist gave you the following report:"Inadequate film - over-exposed and missing right costophrenic/lateral region. Endotracheal tube visible and properly positioned. A moderate left pneumothorax is present, with an air-fluid level and surgical emphysema throughout the soft tissues..."
Do you ignore this and continue positive pressure ventilation on your trauma patient until you can get a better film? Do you wish your radiologist had instead simply refused to comment when he noted that the film was inadequate?
In all of the above examples we would all see the need to repeat the test in order to get a result we required but which could not be obtained, but I think there is merit in avoiding the waste of what IS reliable in the search for the eventual perfection we do expect and know we will get in these cases eventually.
Having said all that, I guess there would be the added curiosity, in a paid-per-item-profit-driven system... Can they "bill" the patient for an investigation which is inadequate? If they don't bill, then why should the patient get the result with no profit to the lab for a sample which was faulty through no error of theirs? What if the policy is NOT to bill for the X-ray in a case like the one I used above, with the "guarantee" that there will be a re-X-ray that COULD be billed, but then the doc decides to wait and NOT repeat the film until AFTER the chest drain has been inserted, thus a case which should have had two films billed only has one? Does that come out of the radiographer's monthly bonus? ;-)
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