Taming the SRU
thinking critical care | a blog for thinking docs: blending good evidence, physiology, common sense, and applying it at the beds
MEDEST | Prehospital Emergency Medicine
Description: where everything is up for debate . . .
Acute gastrointestinal disorders are some of the most frequent problems evaluated by ED physicians. Complaints of diarrhea account for almost 5% of visits to the emergency departments ( Bitterman, 1988 ). Although the disease entity is extremely prevalent and current evidence on the subject is nothing short of “voluminous,” practice differences among ED physicians in its evaluation and management are as varied and inconsistent as the stools themselves.
1. When do you send stool cultures, stool ovum and parasites, and/or fecal WBC? How do you use the results in diagnosis and management?
Stool evaluation of fecal leukocytes (WBC) and occult blood is sent in many ED’s as a positive result has traditionally been thought to be predictive of either an inflammatory or infectious etiology of the diarrhea. Fecal WBC’s and RBC’s are generally found in stool infected with invasive bacterial pathogens such as Salmonella, Shigella , Campylobacter, Enteroinvasive E-coli, Enterohemorrhagic E-col i ( E -coli 0157-H7) , but also in stools of patients with inflammatory disorders such as Crohn’s dise
Taming the SRU
thinking critical care | a blog for thinking docs: blending good evidence, physiology, common sense, and applying it at the beds
MEDEST | Prehospital Emergency Medicine