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Immediate emergency ?Rating: (votes: 0) What specifically are you asking? When to call the patient's physician? Comment:
Quote from AltraWhat specifically are you asking? When to call the patient's physician?
Comment:
What kind of setting ? Clinic? Outpatient center? Surgicenter ? LTC ? Home ?
Comment:
A possible infected trach is urgent enough to call the MD- if a patient with a trach is febrile, it's pretty standard to do a sputum culture- but not necessarily urgent enough to warrant a code, rapid response or transfer to a higher level of care like, say, sepsis is.ETA- there are many situations that are not "immediate emergencies" that still warrant a call to the MD. Any fever of 38.5 C or greater warranted a call at my hospital.
Comment:
It varies by specialty, pt disease, medications and physician.A temp of 38 (100.5) or higher, in a fresh postoperative pt that is otherwise healthy is usually not a big deal. The same temp in a recently induced leukemic pt with an ANC of <50 is a life threatening issue. A platelet count of 35k in the same leukemic = not a big deal. In a surgical pt, needs immediate attention.
Comment:
Lots of shades of grey here. What other s/s is the patient exhibiting (airway obstruction, fever, change in mentation?), is the patient immune compromised? How old is the patient and in what setting are you working? What makes you think the trach may be infected?
Comment:
Widespread bloodstream infection, sepsis, is an emergency. I have seen patients crash because they've become so hypotensive. They usually get a central line placed so that we can infuse dopamine or levophed to help their BP.
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