The flash player was unable to start. If you have a flash blocker then try unblocking the flash content - it should be visible below.
Does that blood in the urine of the elderly man with acute back pain seal the diagnosis of ureteral colic? Probably not.
Jim B. - May 17, 2016 7:23 AM
Dear EM Rappers,
Having just received the sales pitch from the PCT sales person, are there any good studies speaking to its ED utility or lack thereof ? Have serious studies actually verified its mystical ability to differentiate viral and bacterial infections and guide the treatment of sepsis ?
Thanks
Rob O - May 21, 2016 3:39 PM
Hi Jim,
In the below post, there is a link to the article "Procalcitonin algorithm in critically ill adults with undifferentiated infection or suspected sepsis. A randomized controlled trial"
We will have a segment in the near future addressing your specific question.
If you want the punchline/conclusion of the study... In critically ill adults with undifferentiated infections, a PCT algorithm including 0.1 ng/ml cut-off did not achieve 25% reduction in duration of antibiotic treatment
Bilgehan O. - May 21, 2016 3:25 PM
http://www.ncbi.nlm.nih.gov/pubmed/?term=25295709
Bilgehan O. - May 21, 2016 3:28 PM
i also like this http://emcrit.org/emnerd/the-valley-of-fear/
Jim B. - May 29, 2016 8:37 PM
Thanks for the synopsis and the suggestion of the two articles, both edifying.
Kevin K. - July 9, 2016 9:23 PM
Hey EM Rap(pers),
So, I listened to the discussion of abdominal seatbelt signs with great interest. Fascinating stuff. Decided to do a lit search. Seems that seat belt sign on the chest also connotes a higher risk of internal injury.
However, here is my question, one that I have not been able to find an answer:
What EXACTLY constitutes a seatbelt sign?
Now, I'm not talking about the large, deep contusion across the lower abdomen. That is clearly a seatbelt sign. However, my residents are constantly pointing to little, tiny abrasions over bony prominences (most notably the pelvic ASIS and clavicle) and calling it a seatbelt sign in an otherwise normal patient. I'm a pretty strong believer in NOT whole-body CT scanning everyone who has trauma. However, this discussion on seatbelt signs has given me some pause... do I need to increase my scanning? *GASP*
Thanks!
Kevin