ER 101

Diagnostic Tests in the ER

Blood TestsHere’s a quick look at the most common diagnostic tests in the emergency department and what you can expect if your physician orders one for you.

Electrocardiogram (EGG or EKG). Using electrodes placed on the arms, legs, and chest, this test records the electrical activity of the heart. An EKG can spot signs of cardiac problems, such as heart attack and irregular heart rhythm.

Blood test. These are used to look at blood counts (anemia); identify infections; reveal how well the blood is clotting; and evaluate electrolyte composition of bodily fluids, which can determine if a patient is dehydrated or low on sodium or potassium. Occasionally, a blood test will be ordered to hone in on a specific organ or confirm a suspected diagnosis. An example is checking liver blood enzymes.

Urine sample. Tests spot urinary infections; screen for metabolic conditions, such as diabetes and liver diseases (analysis detects excess levels of ketones, glucose, and other chemicals in the urine); confirm pregnancy; and diagnose dehydration.

Standard X-ray. X-rays are used to diagnose lung and heart disease, pneumonia, heart failure, broken bones, dislocations, degenerative joint disease, and internal trauma.

CT scan. Technically called computed tomography, a CT scan, as it is commonly known, uses high-dose ionized radiation to provide a three-dimensional picture of the human anatomy. During a CT scan, the patient lies on a table inside a doughnut-shaped machine. An X-ray tube inside the machine rotates around the body and sends small doses of radiation through it at various angles. CT scans can help diagnose bone tumors, cancers, and fractures; detect internal injuries and bleeding; and pinpoint the location of an infection, tumor, or blood clot. Because these tests are more expensive and involve intense radiation exposure that can lead to cancer later on they’re only ordered in specific circumstances.

Magnetic resonance imaging (MRI). MRIs use powerful magnets and radio waves that create a picture of the inside of the body. For an MRI test, the area of the body being studied is placed inside a special machine. MRIs are used to detect tumors, abnormal growths, bleeding, blood vessel diseases, infections, and bone and organ damage in areas of the body including the head, chest, blood vessels, bones and joints, spine, abdomen, and pelvis.

Bedside ultrasound. This test uses a portable machine that creates images generated by ultrasound waves to detect structural or functional abnormalities. It can pick up internal bleeding from, for example, gunshot wounds, car accident injuries, stabbings, and jumps from great heights, as well as pregnancies, ruptured spleens, gallstones, kidney stones, aortic aneurysms, and cardiac problems.

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