Pediatric UTI

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Nurses Edition Commentary

Lisa Chavez, RN and Kathy Garvin, RN
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Ian L., Dr -

Catheterisation in general practice is rare done most general practitioners will go with the bag specimen or clean catch if lucky .
For catheterisation you require one skilled person to catheterise and two to stabilise the wriggly infant .
So you need" resources "
Even then in contraindications to catheterise eg phimosis suprapubic tap under ultrasound guidance is recommended .
So if it is recommended there is going to be considerable Upskilling in general practices .
Nurses could be trained but there a few organised programmes
Another way is in a well looking infant fever over 39C for 24 hrs no source found treat with cefdinir one dose and attempt three clean catches or clean bag specimens over twelve hours instructing the infants parents with written diagrammatic instructions video cast and welcome phone contact with the health professional team if parents get stuck.

Ian L., Dr -

For Teenagers with symptoms of urine frequency and burning culture for STDs is obligatory .

James C. -

Maybe I am recalling this wrong, but was there not a discussion on EmRap some time in the last few years that most pediatric UTI's left untreated do perfectly fine? And I can't say I am checking urines on all kids who are vomiting, just because I can't prove it's a viral illness as my source. We have the concept to NOT treat asymptomatic bacteria in adults, and while it's hard to determine symptoms in a pre verbal child, I don't know if I would treat a UTI in a 2 year old kid with vomiting and fever, who looks good after Zofran and fluids and has a benign abdomen on exam. Am I alone in this?

Sean G., M.D. -

this presentation was solid IMO. Thank u.

Sean G., M.D. -

your HIPPO EM board review is contradictory to this claiming a UA should be straight cathed on a 1 year old w less than 24 hours of fever and well appearing. A lot of the questions there(well a fair minority) are poorly written, can't see any place to give feedback on that site.

Mel H. -

You’ll have to ask them. We don't run that site separate company despite the fact some emrap faculy are on it

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