emDocs - august 27, 2018 - Authors: Delbar K., Cirone M
Edited by Koyfman A and Long B
"Pearls Before Swine
- Recognize that overall clinical impression trumps guidelines. Don’t let a suspicion of low-risk primary infection like cellulitis prevent you from ordering blood cultures in a frankly septic patient.
- Remember, when assessing a patient for bacteremia, one of the strongest physical exam predictors is rigors.
- If suspicion of bacteremia is low to moderate, evidence-based decision rules and algorithms (from Pawlowicz, Shapiro, etc) can be employed to help determine the need for cultures.10,12,13
- In addition to early antibiotics, the EP is responsible for performing source control or arranging for appropriate consultant intervention."
