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<blockquote data-quote="davej1950" data-source="post: 992765" data-attributes="member: 134699"><p>I worked in a hospital pathology laboratory for more than 30 years and had some appalling experiences with doctors managing (or not) diabetics. Two stories, request from a doctor for a blood alcohol. "The patient is lapsing in and out of consciousness and smells strongly of alcohol" In those days we measured alcohol by a roundabout method called osmolality. For the method to work the patients plasma glucose had to be less than 10. The conversation went something like this;</p><p>Me - sorry can't do an alcohol, the patient's blood sugar is too high.</p><p>Doctor - well how can I get an alcohol done?</p><p>Me - I don't think you need to, the glucose level is 51</p><p>Doctor - well they smell strongly of alcohol so I suppose we'll just have to keep an eye on them</p><p>Me - the glucose is 51, what you can smell is acetone, the patient is in a hyperglycaemic coma and is keto-acidotic, I would suggest you transfer her to ICU before she dies.</p><p>Doctor - are you trying to tell me my job</p><p>Me - well someone has to, I'm ringing my consultant now (it was 3am in the morning) and phoning ICU because I'm interested in saving her life even if you're not.</p><p></p><p>ICU came and collected her and when I knocked off at 9am we had got her glucose down to the low 20's and her blood gases were stable.</p><p>I got a verbal warning for my conversation.</p><p></p><p>The second patient was a woman in her late 40's she had previously had an alcohol problem. She was admitted at about 8pm to the private patient ward smelling of "alcohol" and I was requested to do a blood alcohol. Same scenario, glucose through the roof, previously undiagnosed diabetic. Phoned the ward to tell the doc, there were no doctors still on. Asked which consultant she was under, no-one seemed to know, no admitting paperwork. Phoned switchboard to find out who was on medical take, they weren't interested because she was already in hospital. Made umpteen phone calls but couldn't get anyone interested. She died. I wrote out a formal clinical incident form. My lab consultant tore it up in front of me telling me I didn't know the details.</p></blockquote><p></p>
[QUOTE="davej1950, post: 992765, member: 134699"] I worked in a hospital pathology laboratory for more than 30 years and had some appalling experiences with doctors managing (or not) diabetics. Two stories, request from a doctor for a blood alcohol. "The patient is lapsing in and out of consciousness and smells strongly of alcohol" In those days we measured alcohol by a roundabout method called osmolality. For the method to work the patients plasma glucose had to be less than 10. The conversation went something like this; Me - sorry can't do an alcohol, the patient's blood sugar is too high. Doctor - well how can I get an alcohol done? Me - I don't think you need to, the glucose level is 51 Doctor - well they smell strongly of alcohol so I suppose we'll just have to keep an eye on them Me - the glucose is 51, what you can smell is acetone, the patient is in a hyperglycaemic coma and is keto-acidotic, I would suggest you transfer her to ICU before she dies. Doctor - are you trying to tell me my job Me - well someone has to, I'm ringing my consultant now (it was 3am in the morning) and phoning ICU because I'm interested in saving her life even if you're not. ICU came and collected her and when I knocked off at 9am we had got her glucose down to the low 20's and her blood gases were stable. I got a verbal warning for my conversation. The second patient was a woman in her late 40's she had previously had an alcohol problem. She was admitted at about 8pm to the private patient ward smelling of "alcohol" and I was requested to do a blood alcohol. Same scenario, glucose through the roof, previously undiagnosed diabetic. Phoned the ward to tell the doc, there were no doctors still on. Asked which consultant she was under, no-one seemed to know, no admitting paperwork. Phoned switchboard to find out who was on medical take, they weren't interested because she was already in hospital. Made umpteen phone calls but couldn't get anyone interested. She died. I wrote out a formal clinical incident form. My lab consultant tore it up in front of me telling me I didn't know the details. [/QUOTE]
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