tailieunhanh - báo cáo hóa học: " A protocol for the emergency department management of acute undifferentiated febrile illness in India"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành hóa học dành cho các bạn yêu hóa học tham khảo đề tài: A protocol for the emergency department management of acute undifferentiated febrile illness in India | Thangarasu et al. International Journal of Emergency Medicine 2011 4 57 http content 4 1 57 o International Journal of Emergency Medicine a SpringerOpen Journal BRIEF RESEARCH REPORT Open Access A protocol for the emergency department management of acute undifferentiated febrile illness in India Sudhagar Thangarasu1 Piruthiviraj Natarajan2 Parivalavan Rajavelu2 Arjun Rajagopalan3 and Jeremy S Seelinger Devey4 Abstract Background Fever is a common presenting complaint in the developing world but there is a paucity of literature to guide investigation and treatment of the adult patient presenting with fever and no localizing symptoms. Objective The objective of this study was to devise a standardized protocol for the evaluation and treatment of febrile adult patients who have no localizing symptoms in order to reduce unnecessary testing and inappropriate antimicrobial use. After devising the protocol a pilot study was performed to assess its feasibility in the emergency department. Methods A protocol was formulated for adult patients presenting with fever who had no clinical evidence of sepsis and no localizing symptoms to suggest the etiology of their fever. Investigations were based on duration of fever with no investigations indicated prior to day 3. Treatment was guided by results of investigations. A pilot study was performed after protocol implementation wherein data were collected on successive adult patients presenting with fever. Results During the 6-week study period 342 patients presented with fever 209 of whom fit the parameters of the protocol with 113 of these patients presenting on the 1st or 2nd day of fever. All patients experienced defervescence of fever with ten patients being lost to follow-up. Of the patients presenting on day 1 or 2 of fever 85 113 defervesced without the need for testing 60 113 experienced defervescence without the need for antimicrobial therapy. Conclusion Implementation of this rational standardized .