Síguenos en Twitter     Síguenos en Facebook     Síguenos en YouTube     Siguenos en Linkedin     Correo Salutsantjoan     Gmail     Dropbox     Instagram     Google Drive     StumbleUpon     StumbleUpon     StumbleUpon     StumbleUpon     StumbleUpon     StumbleUpon     StumbleUpon


My photo
FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com




Friday, July 15, 2016

Evidence-based Approach to Urinalysis in the ED

Las Vegas Emergency Medicine - 7/13/2016 - By Aaron Heckelman
"Every day in the ED we see patients with vague, nonspecific abdominal pain, and in a lot of EDs a clean-catch urinalysis is part of these patients’ standard lab workup. And in a lot of ED’s there is great variation in the way different providers interpret those urinalyses and decide who gets diagnosed with, and treated for, a UTI. So what does the evidence say about this? Not as much as you’d hope – despite being such a common laboratory test, data on how good urinalysis is at predicting UTI (defined by symptoms plus a positive urine culture) is surprisingly sparse and inconsistent. Hence all the practice variation. But after an extensive literature review, here are the best evidence-based answers I could produce to some questions we face every day in the ED.
Note that this literature review applies only to female adult patients. Laboratory definition of a “positive urine culture” varies a little between labs and studies, but usually is defined as a culture that grows out >104-105 colony forming units of a single organism. Definition of a “contaminated culture” similarly varies, but is usually one that grows out multiple organisms, or <104-105 of a single organism..."