Cedars-Sinai Medical Center

medical staff pulse newsletter

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A BI-WEEKLY PUBLICATION FROM THE CEDARS-SINAI CHIEF OF STAFF July 17, 2015 | Archived Issues

P & T Approvals, FDA Warnings About Codeine-Containing Meds, NSAIDs, Proglycem

Pharmacy Focus

See highlights of the June meeting of the Pharmacy and Therapeutics Committee. Also, the U.S. Food and Drug Administration has issued warnings about codeine-containing medicines in children, nonsteroidal anti-inflammatory drugs and Proglycem in infants.

» Read more


Meetings and Events


Grand Rounds

Click here to view upcoming grand rounds.


Upcoming CME Conferences

Click below to view a complete list of all scheduled Continuing Medical Education conferences.

CME Newsletter - July 2015 (PDF)


Milestones

Do you know of a significant event in the life of a medical staff member? Please let us know, and we'll post these milestones in Medical Staff Pulse. Also, feel free to submit comments on milestones, and we'll post the comments in the next issue. Click here to email us your milestones and comments.

Share Your News

Won any awards or had an article accepted for publication? Share your news about professional achievements and other items of interest.

Click here to share your news

Use New Reflex Test for Ionized Calcium

Attention frequent users of calcium testing: Please order an ionized calcium reflex test, not ionized calcium directly.

On June 30, the Core Lab began offering a reflex to ionized calcium when total calcium is abnormal. In the vast majority of instances, this reflex should be ordered instead of ionized calcium directly. Research has shown that the majority of ionized calcium orders are clinically unnecessary.

The Core Lab runs more than 45,000 ionized calcium tests annually, which often wastes laboratory labor and resources. When total calcium is normal, ionized calcium should be normal, except in critically ill patients or patients with signs and symptoms consistent with hypocalcemia.

When ionized calcium is directly ordered unnecessarily, this not only increases testing expense on a per-patient basis (this test is often ordered daily) but can result in unnecessary IV calcium gluconate administration.

When this new reflex is ordered, total calcium will be tested first. This is already part of both basic and comprehensive metabolic panels. If the total calcium result is <8.0 mg/dL or >10.2 mg/dL, the patient's sample will be reflexed to ionized calcium. This reflex can be performed both with serum or heparinized plasma specimens.

Please start using this reflex for the majority of your patients who are not critically ill and who do not have signs and symptoms consistent with hypocalcemia. Order codes are as follows:

  • iCa reflex with Basic Metabolic Panel: CM1RC
  • iCa reflex with Comprehensive Metabolic Panel: CMPRC
  • Total Ca to iCa reflex: CARC

Please contact Kimia Sobhani, PhD, or Holli Mason, MD, with questions.