LDH

Ian, I’ve done some ‘routine bloods’ and…” are the words most likely to increase my blood pressure at work. I’m not alone in detesting the taking of ‘routine bloods’ – if the test you’re doing isn’t going to change your management, then don’t do it.

Equally, if you don’t know what to do with an abnormal result, you need to think hard about why you suggest the test. If you do enough blood tests, eventually, you’ll find one that is abnormal. What then?

My pet peeve for this approach is using LDH in the Paediatric ED and primary care. I’ve had plenty of discussions with anxious healthcare professionals who have undertaken a ‘routine’ LDH and are now wishing they hadn’t; as it is, it has come back as moderately raised.

Ross and Abrahamson examined this problem and published their findings in the Archives of Disease in Childhood. Just how useful is taking an LDH in children presenting to the Paediatric ED?

Ross, A.D. and Abrahamson, E., 2011. A review of the use of serum lactate dehydrogenase measurement in patients presenting to the paediatric emergency department. Archives of Disease in Childhood, 96(Suppl 1), pp.A87-A87.