Laboratory evaluation

Serial hematocrit measurements may provide an estimate of the amount of ongoing blood loss, as long as hemodynamic stability is maintained. Persistently elevated amylase levels suggest injury of the pancreas. An initially elevated serum amylase level is of little diagnostic help, particularly if there are facial injuries with salivary gland injury. Fractionation of serum amylase, if available, may be of some assistance in differentiating pancreatic injury. A urinalysis showing 50 or more red cells per high-power field usually indicates a need for radiological evaluation of the urinary tract.

In patients with head or chest injuries, frequent arterial blood gas analyses are mandatory to guide respiratory therapy. Measurements of serum osmolarity may be required every 6 h in patients who are receiving mannitol therapy for raised intracranial pressure. Blood glucose and electrolyte values should also be evaluated every 6 to 12 h in such patients.

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