Do peripheral blood cultures taken in the emergency department influence clinical management?
- Correspondence to: Dr P T Munro Accident and Emergency Department, Southern General Hospital, 1345 Govan Road, Glasgow, G51 4TF UK; phil.munro{at}sgh.scot.nhs.uk
- Accepted 22 November 2006
Abstract
Background: Blood cultures are routinely used to investigate suspected sepsis in the emergency department despite several studies demonstrating 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 patient 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 cases 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 rarely yield bacterial growth and over 2 years, only four seemed to directly influence patient management. Better guidelines are required for targeted use of blood cultures in the emergency department.
Footnotes
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JFG completed and wrote the original pilot study. NH undertook the data collection and analysis of the main study. PM developed the original idea and wrote the paper along with JFG and NH. PM is the guarantor.
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Funding: None.
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Competing interests: None.
