Emergency Physician Questions Blood Tests

What are the blood tests necessary in a ER?

Once a patient is taken to the ER, I suppose there are some required blood tests. What are the tests that will have to be done? The reason why I want to know this is because my father recently had to go to the ER for an awful migraine that my mom couldn't manage at home. I wasn't around for this, but my father doesn't remember what tests they did in the ER

8 Answers

There are no specific tests that are routinely done in the ED. Once a patient is evaluated by a healthcare professional based on his or her exam and the chief complaints series of labs and imaging are ordered.
if he is older than 50 is prudent to have a sedimentation rate; if the headache is much worse than usual and he has hypertension then coagulation studies and a head CT
Basic tests like CBC, comprehensive metabolic panel, and CT head.
There is not a set of tests for every patient in the ER. The tests we do depend on the patient's problem, age, vital signs, and other factors. So, we often do tests, but it is not a "one size fits all" type of thing. It is very individual, dependent on the patient's condition. For migraines, sometimes there aren't any tests that need to be done. Some migraine patients might need a head CT scan, especially if it's their first migraine, or if it's the worst headache they've ever had.
There are no hard and fast rules that every patient has to have a set of tests. It depends on the "chief complaint" and what the physician finds on the physical examination. I would hope every doctor takes a good history and does a thorough physical exam on every patient and then decides to order "necessary tests." Common tests are CBC, blood chemistry, urine test and maybe a chest X-ray (again, depending on the patient complaint). CT scans and MRIs, ultrasounds are special tests, don't when the doctor considers serious, complicated diagnosis (e.g., brain bleed, blood clot, etc.).
Hope this helps.
There is no specific answer for this honestly. Each patient should be assessed and treated on an individual basis and tests should be ordered based on their presentation and complaint. Without knowing more there is no way to say what lab tests should have been done. Or if any needed to be done at all.
TC
There are no mandatory tests from the ED. Always depends on presentation and symptoms.
Blood test, or any test performed in the emergency department depend entirely on the patient’s presenting symptom and the physician’s interpretation of what the source may be of the patient’s condition. If your father has a history of migraines and his headache was identical or quite similar to previous headaches, the physician may not have run any tests and simply have treated the headache. If there was a concern that infection was the source he would have run a panel of labs and if he was concerned that some type of structural problem (mass, bleeding) may be the source of the problem, he would have ordered various types of imaging depending on what he was looking for.

Since all of these test have associated costs, physicians attempt to appropriately order test when they believe there is a true likelihood of a given disease process or a disease process that cannot be sorted out without testing. Migraine headaches are often diagnosed by clinical presentations, history and physical exam alone.