None listed
Conditions
Brief summary
Research Question Can measurements of lactate clearance with a point of care lactate measuring device (StatStripAccutrend) assist in the management and early identification of patients at higher risk of deterioration in the emergency department? Rationale for Current Study In the emergency department, the undifferentiated patient presents a diagnostic and time management challenge. Lactate is used as a surrogate marker for global hypoperfusion in sepsis, trauma and patients with surgical abdomens, but there are also other areas of developing interest where lactate measurements could be used to assist in fast tracking decisions and risk stratifying patients to decide their disposition. Primary Objective 1. To measure serial lactate measurements in the ED within the first hour of presentation and at 3 hours of stay to monitor and predict deterioration in the department or the hospital in the first 72 hours? STUDY DESIGN This study is a prospective longitudinal study where data will be collected over a year. The data will be collected with written or and verbal consent, and fact sheet given to the participant about the study. Verbal and written consent will be obtained at the first reading and second readings taken to make sure that participants are happy to continue with the study. Patients can withdraw at any time in the study. Exclusion criteria of patients will include those that are <18 years old, severe hepatic failure, presentation of known seizure disorders and those triaged to other areas apart from the adult acute area or self discharged from the department before completion of treatment, if they don’t have a serial measurement of their lactate at 3 hours. The lactate measurements will be recorded at a time within one hour of presentation and the second reading at 3 hours of presentation electronically on their medical records. The data will then be extracted and de-identified for this research project and determined if the participant is to be excluded or included in the study. . This study to reach the sample size of 1000 participants would approximately go over the course of 6 months to a year.
Interventions
We will be observing lactate clearance in the emergency department patient that are undifferentiated and unwell adult patients and if this is a useful tool in identifying the deteriorating patient early and those that need to be admitted into hospital for care. These patients will have their capillary/venous/arterial lactate recorded by a point of care device from Nova Biomedical measured at 1 hour and 3 hours of stay. Their readings and clearance and range will be looked at and their patient
We will be observing lactate clearance in the emergency department patient that are undifferentiated and unwell adult patients and if this is a useful tool in identifying the deteriorating patient early and those that need to be admitted into hospital for care. These patients will have their capillary/venous/arterial lactate recorded by a point of care device from Nova Biomedical measured at 1 hour and 3 hours of stay. Their readings and clearance and range will be looked at and their patient disposition ie discharge point to home, hospital, critical care unit and deaths. Their outcome will be observed for 72 hours post leaving the Emergency Department. These lactate measurements will be taken from different groups of patients in the emergency department at different times so that it allows for staff to focus on one group at a time eg sepsis patients, patients with shortness of breath.
Sponsors
Louisa Ng
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
- Person greater than or equal to 18 years of age - Triaged for assessment in adult acute assessment
Exclusion criteria
Exclusion of persons with the following comorbidities/presentation: 1. Seizure 2. Severe hepatic failure 3. Patients that did not stay for their treatment in the department 4. Biguanide therapy (phenformin, metformin) 5. Patients unable to give consent eg low GCS, dementia
Outcome results
None listed