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Does that blood in the urine of the elderly man with acute back pain seal the diagnosis of ureteral colic? Probably not.
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
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
i also like this http://emcrit.org/emnerd/the-valley-of-fear/
Thanks for the synopsis and the suggestion of the two articles, both edifying.
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*
What you do matters.