Blood culture use in the emergency department in patients hospitalized with respiratory symptoms due to a nonpneumonia illness

Abstract Objectives This study aimed to describe the development and implementation of a separated pathway to check and treat patients with a suspected/confirmed coronavirus disease 2019 (COVID-19) in the emergency department (ED) at King Abdullah bin Abdulaziz University Hospital in Riyadh. Methods We conducted a retrospective, descriptive longitudinal study from March to July 2020 by analyzing data of all confirmed cases of COVID-19 among ED visitors and healthcare workers in King Abdullah bin Abdulaziz University Hospital. Results During the study period, a total of 1,182 swab samples were collected for testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), of which 285 (24.1%) tested positive. Of the 285 cases of confirmed SARS-CoV-2 infection, 18 were healthcare workers and 267 were patients. As a result of using the respiratory pathway for COVID-19 patients, the hospital managed to limit transmission of SARS-CoV-2 not only between patients but also between patients and healthcare workers, while also containing the pandemic. There were no cases of nosocomial SARS-CoV-2 infection recorded among the patients who visited the ED or the flu clinic. All confirmed cases were community acquired and patients were cared for under constrained measures. Conclusions Implementing infection control measures and restricting those with respiratory symptoms to the ED pathway prevented nosocomial spread of SARS-CoV-2 infection in the ED.

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Group IIA secretory phospholipase 2 independently predicts mortality and positive blood culture in emergency department sepsis patients

Journal of the American College of Emergency Physicians Open ◽

10.1002/emp2.12460 ◽

2021 ◽

Vol 2 (3) ◽

Author(s):

Utsav Nandi ◽

Alan E. Jones ◽

Michael A. Puskarich

Keyword(s):

Emergency Department ◽

Blood Culture ◽

Positive Blood Culture ◽

Secretory Phospholipase

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School Nurses on the Front Lines of Medicine: Take a BREATH: The Approach to a Student With Respiratory Distress

NASN School Nurse ◽

10.1177/1942602x17740142 ◽

2017 ◽

Vol 33 (1) ◽

pp. 29-35 ◽

Cited By ~ 3

Author(s):

Morgann Loaec ◽

Robert P. Olympia

Keyword(s):

Emergency Department ◽

Respiratory Distress ◽

Respiratory Symptoms ◽

School Setting ◽

School Nurses ◽

Initial Assessment ◽

Level Of Care ◽

Primary Health ◽

Life Threatening

Students presenting with varying degrees of respiratory symptoms and distress occur commonly in the school setting. It is important to develop a differential diagnosis for respiratory distress, to initiate stabilization of the student with life-threatening symptoms, and to triage these students to an appropriate level of care (back to the classroom, home with their guardian with follow up at their primary health care provider’s office, or directly to the closest emergency department via Emergency Medical Services). This article describes the initial assessment and management of a student presenting with respiratory distress.

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Decreasing Blood Culture Contaminants in a Pediatric Emergency Department

Pediatric Quality and Safety ◽

10.1097/pq9.0000000000000104 ◽

2018 ◽

Vol 3 (5) ◽

pp. e104 ◽

Cited By ~ 2

Author(s):

Paul C. Mullan ◽

Sara Scott ◽

James M. Chamberlain ◽

Jeanne Pettinichi ◽

Katura Palacious ◽

...

Keyword(s):

Emergency Department ◽

Blood Culture ◽

Pediatric Emergency ◽

Pediatric Emergency Department

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Comparison of the Contamination Rate and Risk Factor Profile of Blood Culture Done in Emergency Department and MHDU/MICUs

Global Journal of Medical Research ◽

10.34257/mrcvol21is2pg1 ◽

2021 ◽

pp. 1-8

Author(s):

Dr. Pankaj Kumar Singh

Keyword(s):

Risk Factors ◽

Emergency Department ◽

Risk Factor ◽

Blood Culture ◽

Observational Study ◽

Prospective Observational Study ◽

Contamination Rate ◽

Medical Illness ◽

Inclusion Criteria ◽

Factors Associated

Aims and objectives: To determine the risk factors of blood culture contamination done in ED and those done in the MHDU/MICU among patients admitted with medical illness. Material and Methods: This is a two months’ prospective observational study comparing blood culture contamination rate and risk factors associated with contamination between ED and MICU/MHDU. A total of 998 patients were included in the study who underwent blood culture in ED and MICU/MHDU. 570 in ED and 428 in MICU/MHDU were included after meeting exclusion and inclusion criteria. Results: Blood culture growths were higher in ED (19%). Most common growth was CoNS (4%). The overall contamination rate in this study was (4.8%) The contamination rate was lower in ED (4.4%) when compared to MICU/MHDU (5.4%).

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Neither Blood Culture Positivity nor Time to Positivity is Associated with Mortality among Patients Presenting with Severe Manifestations of Sepsis: The FABLED Cohort Study

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab321 ◽

2021 ◽

Author(s):

Katryn Paquette ◽

David Sweet ◽

Robert Stenstrom ◽

Sarah N Stabler ◽

Alexander Lawandi ◽

...

Keyword(s):

Emergency Department ◽

Cohort Study ◽

Blood Culture ◽

Blood Cultures ◽

Cell Counts ◽

Culture Positivity ◽

Time To Positivity ◽

Blood Culture Positivity ◽

Normal White Blood Cell ◽

Support Fund

Abstract Background Sepsis is a leading cause of morbidity, mortality, and health care costs worldwide. Methods We conducted a multi-center, prospective cohort study evaluating the yield of blood cultures drawn before and after empiric antimicrobial administration among adults presenting to the emergency department with severe manifestations of sepsis (ClinicalTrials.gov: NCT01867905). Enrolled patients who had the requisite blood cultures drawn were followed for 90 days. We explored the independent association between blood culture positivity and its time to positivity in relation to 90-day mortality. Findings 325 participants were enrolled; 90-day mortality among the 315 subjects followed-up was 25·4% (80/315). Mortality was associated with age (mean age in those who died was 72·5 ±15·8 vs. 62·9 ±17·7 years among survivors, p<0·0001), greater Charlson Comorbidity Index (2 (IQR 1,3) vs. 1 (IQR 0,3), p=0·008), dementia (13/80 (16·2%) vs. 18/235 (7·7%), p=0·03), cancer (27/80 (33·8%) vs. 47/235 (20·0%), p=0·015), positive qSOFA score (57/80 (71·2%) vs. 129/235 (54·9%), p=0·009), and normal white blood cell counts (25/80 (31·2%) vs. 42/235 (17·9%), p=0·02). The presence of bacteremia, persistent bacteremia after antimicrobial infusion, and shorter time to blood culture positivity were not associated with mortality. Neither the source of infection nor pathogen affected mortality. Interpretation Although severe sepsis is an inflammatory condition triggered by infection, its 90-day survival is not influenced by blood culture positivity nor its time to positivity. Funding Vancouver Coastal Health; St-Paul’s Hospital Foundation Emergency Department Support Fund; the Fonds de Recherche Santé – Québec (CPY); Intramural Research Program of the NIH, Clinical Center (AL); the Maricopa Medical Foundation

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Dirty Lines and False Alarms: Blood Culture Contamination in the Emergency Department

American Journal of Infection Control ◽

10.1016/j.ajic.2017.04.088 ◽

2017 ◽

Vol 45 (6) ◽

pp. S58

Author(s):

Alexander Sundermann ◽

Brittney Golden ◽

Matthew Vendeville ◽

Ashley Querry ◽

William Pasculle

Keyword(s):

Emergency Department ◽

Blood Culture ◽

False Alarms

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410 Higher Nursing Care Level Is Associated with Higher Incidences of Blood Culture Contamination in Emergency Department

Annals of Emergency Medicine ◽

10.1016/j.annemergmed.2020.09.426 ◽

2020 ◽

Vol 76 (4) ◽

pp. S156-S157

Author(s):

A. Shigeno ◽

Y. Homma ◽

T. Yokoi ◽

S. Tanaka ◽

R. Onodera ◽

...

Keyword(s):

Emergency Department ◽

Blood Culture ◽

Nursing Care ◽

Care Level

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Suicide after inhaling a pyrethrins containing insecticide spray

BMJ Case Reports ◽

10.1136/bcr-2018-227936 ◽

2019 ◽

Vol 12 (4) ◽

pp. e227936 ◽

Cited By ~ 1

Author(s):

L R van den Bersselaar ◽

J G van der Hoeven ◽

B de Jong

Keyword(s):

Emergency Department ◽

Mechanical Ventilation ◽

Respiratory Failure ◽

Respiratory Symptoms ◽

Pulmonary Inflammation ◽

Developed Countries ◽

Aggressive Treatment ◽

Predominant Symptom ◽

Suicide Case ◽

Insecticide Spray

Pesticide self-poisoning is rare in developed countries. We report a suicide case after inhalation of a pyrethrins containing insecticide spray. The patient presented at the emergency department with respiratory failure. Despite mechanical ventilation, he developed severe pulmonary inflammation with a systemic inflammatory response syndrome and died 5 days later. Studies reporting on acute pyrethrins or pyrethroids insecticide poisoning in both occupational and non-occupational cases usually describe mild and self-limiting respiratory symptoms as the predominant symptom. Severe or fatal cases of pyrethrins or pyrethroids poisoning are very rare. Patients with asthma or allergies are apparently more at risk for severe symptoms. In these cases, early and aggressive treatment with bronchodilatators, steroids, antihistamines and epinephrine should be considered.

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Endotracheal Metastasis Causing Airway Obstruction

Clinical Practice and Cases in Emergency Medicine ◽

10.5811/cpcem.2019.10.44964 ◽

2020 ◽

Vol 4 (1) ◽

pp. 96-98

Author(s):

Yudai Yano ◽

Takashi Fujiwara ◽

Masanobu Mizuta

Keyword(s):

Computed Tomography ◽

Lung Cancer ◽

Emergency Department ◽

Differential Diagnosis ◽

Respiratory Symptoms ◽

Primary Lung Cancer ◽

Chest Computed Tomography ◽

Important Differential Diagnosis ◽

Emergency Tracheostomy ◽

Rare Lesion

Endotracheal metastasis, a critical complication of primary lung cancer, is an extremely rare lesion. A 73-year-old woman who had previously received treatment for lung cancer presented to our emergency department with dyspnea. A chest computed tomography and nasopharyngolaryngoscopy showed an endotracheal mass below the epiglottis, obstructing the trachea almost completely. The patient had an emergency tracheostomy, and then the mass was removed via median laryngotomy. This lesion was proven to be a recurrent metastasis of lung cancer. Clinicians should recognize endotracheal metastasis as an important differential diagnosis in cancer patients presenting with respiratory symptoms.

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