Monday, July 12, 2021

Disposition of Pneumonia

EmDocs - July 12, 2021 - By Trevor Cerbini and Richard Sinert
Reviewed by: Andrew Grock, Alex Koyfman, Brit Long
Take Home Points:
  • ACEP and the IDSA/ATS guidelines recommend a clinical prediction rule in combination with clinician judgement to determine patient disposition for adults with CAP.
  • The PSI score identifies a large portion of low-risk patients potentially suitable for outpatient care, but should be used with clinical judgment! Be aware of excluded populations that the PSI score should not be used in.
  • Consider admitting patients with significant hypoxia, hypotension, tachycardia, or renal failure, regardless of PSI score.
  • Likewise, patients demonstrating an inability to comply with an outpatient antibiotic regimen (psychosocial factors, substance use, cognitive deficiencies, or PO intolerance) should also be considered for inpatient care.
  • ED admission to a higher-level care setting should be considered for patients with 3 or more IDSA/ATS 2007 minor criteria