Kelly A M
Department of Emergency Medicine, Western Hospital, Footscray, Australia.
J Accid Emerg Med. 1998 Jul;15(4):254-6. doi: 10.1136/emj.15.4.254.
(1) To establish the proportion of blood cultures that yield a positive microbiological culture. (2) To determine what proportion of blood cultures taken in the emergency department impact on patient management. (3) To develop guidelines for the appropriate ordering of blood cultures from patients in the emergency department (ED).
Retrospective review of all blood cultures taken in the ED of a metropolitan teaching hospital between 26 September 1995 and 30 June 1996.
One thousand and sixty two blood cultures were taken from patients in the ED during the study period. Ninety two (9%) returned a positive microbiological culture. Of these, 52 (5%) were "true" positives and 18 (1.6%) resulted in changes in management.
Blood cultures taken in the ED rarely yield positive cultures. Only 1.6% of blood cultures taken in the ED impact on management of patients. Simple strategies could reduce the number of blood cultures ordered with little prospect of patient compromise.
(1)确定血培养微生物培养呈阳性的比例。(2)确定急诊科采集的血培养对患者治疗产生影响的比例。(3)制定急诊科患者血培养合理医嘱的指南。
回顾性分析1995年9月26日至1996年6月30日期间一家大都市教学医院急诊科采集的所有血培养。
研究期间急诊科患者共采集了1062份血培养。92份(9%)微生物培养呈阳性。其中,52份(5%)为“真”阳性,18份(1.6%)导致了治疗方案的改变。
急诊科采集的血培养很少得到阳性培养结果。急诊科采集的血培养仅1.6%对患者治疗有影响。简单的策略可以减少血培养的医嘱数量,而几乎不会对患者造成不利影响。