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Do peripheral blood cultures taken in the emergency department influence clinical management?
  1. Philip T Munro,
  2. Neil Howie,
  3. Jan F Gerstenmaier
  1. Emergency Department, Southern General Hospital, Glasgow, UK
  1. Correspondence to:
 Dr P T Munro
 Department of Emergency Medicine, Southern General Hospital, 1345 Govan Road, Glasgow G51 4TF, UK; phil.munro{at}sgh.scot.nhs.uk

Abstract

Background: Blood cultures are routinely used to investigate suspected sepsis in the emergency department despite several studies showing their limited influence on patient management.

Objectives: To quantify the use and clinical relevance of blood cultures obtained in the emergency department.

Methods: A retrospective study of blood cultures taken in the emergency department between 1 January 2003 and 31 December 2004. Microbiology results and patients’ records were reviewed to determine the influence of positive cultures on subsequent patient management.

Results: 2213 blood cultures were taken in the emergency department over the study period. 132 (6%) yielded a positive result. Three positive cultures had incomplete information. Of the remaining 129 positive cultures, 30 (1.4% of all cultures) were “true positives” and 4 (0.18%) influenced subsequent patient management.

Conclusions: Blood cultures taken in our emergency department (Southern General Hospital, Glasgow, UK) rarely yield bacterial growth, and over 2 years only four cultures seemed to directly influence patient management. Better guidelines are required for targeted use of blood cultures in the emergency department.

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Footnotes

  • Competing interests: None.

  • JFG completed and wrote the original pilot study; NH undertook the data collection and analysis of the main study. PTM developed the original idea and wrote the paper along with JFG and NH. PTM is the guarantor.

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