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Rebellion in EM 2019: 3 Things That Have Changed the Way I Intubate

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lunes, 2 de abril de 2018

Urine Testing

emDocs - April 2, 2018 - Author: Long B - / Edited by: Koyfman A
"Key Points
  • UTI is a clinical diagnosis (dysuria, frequency, etc.). Urine that is cloudy or “smelly” is not diagnostic of UTI. LE or nitrites alone without symptoms does not require treatment.
  • Patients with simple, routine UTI do not require urine cultures. Patients with complicated UTI, pyelonephritis, failed treatment, or recent antibiotic therapy should have urine cultures obtained.
  • Bacteriuria in the absence of symptoms defines asymptomatic bacteriuria, which should not be routinely treated.
  • Patients with dementia and falls or those with altered mental status and no ability to provide a history of urinary symptoms can be difficult. Negative nitrite and LE rules out UTI in ASB and in patients for whom exam is challenging.
  • Other markers of systemic inflammation should be used for diagnosis if history or exam are unreliable."