Pneumonia Reboot: Admit or Discharge Decisions

CXR of a 37-yr-old male with pneumonia and abscess. (Photo from Wikicommons).

CT scan of the chest showing bilateral pneumonia with abscesses, effusions, and caverns. 37 year old male. (Photo from Wikicommons)

The case as presented in the January 2018 EMRAP files:

A 73-year-old male with a history of hypertension, hyperlipidemia and aortic stenosis presented with cough, fever and sputum. He was mildly tachycardic but not tachypneic and was well-appearing. On lung exam, he had some focal wheezes in the left lower lobe. Swaminathan thought the patient had pneumonia. Chest x-ray confirmed a left lower lobe infiltrate.

Now what? What else do you need to know about this patient that impacts discharge planning. It’s flu season here in the USA, the ED and wards are filled with critical patients and beds are in high demand. Do you really need to admit this patient? Tie up a bed? Expose him to hospital-acquired infections?

Listen to the January EMRAP Introduction podcast or read the PDF by Rob Orman MD and Anand Swaminathan MD to find guidance and opinions.

Who knew? The CURB-65 and the PORT Score can help you make these difficult decisions.

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