> Date: Mon, 20 Feb 2012 21:56:58 -0500
> From: [log in to unmask]
> Subject: Re: RSV testing in non admitted patients
> To: [log in to unmask]
> 1. Are PEM docs testing for RSV in patients who are clinically OK to be discharged? Not typically, however the residents and nurses frequently beat me to the decidsion. Plus some of my colleagues are not on the same page..I do test when fever is present and the parents have "doctor" shopped...
> 2. Do you have a patient age that determines your decision? not especially, though the babies < 4 months of age who who were premies ( < 34 weekers) or have other consdition associated with > risk are mor elikely to get tested. When an infant is 1month< patient < 2 month of age and has fever, I might do a UA/UCX only if the RSV is+. Same is true for those with + influenza. I hold to the caveat mentioned in Larry BAraffs guidelines and others that patients with a readily recognizable viral illness would not need a sepsis work up. Of course if the baby is symptomatic to the point that they have AMS or are otherwise impaired, I go full bore..
> 3. Do you admit RSV positive infants who are clinically stable, in no respiratory distress and good sats? I don't.. Not sure how you wold know the end point. SO I use admission criteria like apnea, increased WOB, espeically with marginal or low O2 sats. poor po intake, I do factor in "( arbitrary I grant you) that the baby was term or premature , that they have co-morbidities, and what the their home life and follow up are like. Hope that helps,
Martin Herman, M.D.
Pediatric Emergency Medicine
Sacred Heart Children's Hospital
FSU @ Sacred Heart, Division of Pediatrics
5153 N. 9th Ave, 6th Floor Nemours Bldg
Pensacola, FL 32504
Ph: 850 416 7658(office)
Ph: 901 219 9202 ( cell)
Fx: 850 416 7677
Email: [log in to unmask]
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