RESUMO
Approximately one million patients in the UK present to hospitals each year with head injuries. Almost half are under 16 years of age. (Royal College of Surgeons of England 1999). The majority of patients who attend for treatment will be suffering from a minor head injury. It is stated that some 92% of these patients will have normal neurology (Klauber 1993) and most will be discharged into the care of a responsible adult with instructions and advice for further observation at home. Only 1% of patients attending with a head injury have a skull fracture (Ramrakha & Moore 1997). The aim of this article is to guide the practitioner into ensuring a consistent, evidence-based approach to the assessment of patients with head injury when they present at a Minor Injuries Unit. This includes timely, appropriate referral for further investigation and clinical intervention.
Assuntos
Traumatismos Craniocerebrais/diagnóstico , Traumatismos Craniocerebrais/enfermagem , Enfermagem em Emergência/métodos , Avaliação em Enfermagem/métodos , Triagem/métodos , Adolescente , Adulto , Distribuição por Idade , Fatores Etários , Criança , Traumatismos Craniocerebrais/classificação , Traumatismos Craniocerebrais/epidemiologia , Traumatismos Craniocerebrais/fisiopatologia , Enfermagem em Emergência/normas , Serviço Hospitalar de Emergência , Medicina Baseada em Evidências , Unidades Hospitalares , Humanos , Avaliação em Enfermagem/normas , Admissão do Paciente , Alta do Paciente , Educação de Pacientes como Assunto , Seleção de Pacientes , Guias de Prática Clínica como Assunto , Triagem/normasRESUMO
AIM: To evaluate the Cult-Dip Plus (Merck, Germany), a bacteriological culture test for detecting uropathogens. METHODS: Cult-Dip Plus consists of Brolacin (CLED) and MacConkey agar, each containing methylumbelliferylglucuronide (MUG). Using 1022 urine samples, this product was compared with the routine method of calibrated loop inoculated CLED and blood agar for screening urine for uropathogens. The MUG test for identifying Escherichia coli was also evaluated. RESULTS: Compared with the routine method, Cult-Dip Plus has a sensitivity, specificity, positive predictive value and negative predictive value of 88.3%, 98.0%, 91.9%, and 97.1%, respectively. The MUG test correctly identified 92% of E coli isolates with a sensitivity, specificity and positive predictive value of 91.6%, 95.2%, and 93.6%, respectively. CONCLUSION: Cult-Dip Plus appears to be an alternative method to the calibrate loop method for detecting uropathogens. The MUG test permits rapid, reliable and inexpensive identification of E coli.
Assuntos
Técnicas Bacteriológicas , Infecções Urinárias/microbiologia , Escherichia coli/isolamento & purificação , Estudos de Avaliação como Assunto , Feminino , Humanos , Masculino , Valor Preditivo dos Testes , Estudos Prospectivos , Fitas Reagentes , Sensibilidade e Especificidade , Fatores de Tempo , Infecções Urinárias/diagnósticoRESUMO
The Urotest AB was used to detect antimicrobial substances in urine samples. Of 1022 urine specimens evaluated, Urotest AB detected inhibitors in 38.9%. Of 159 urine specimens from patients thought to be taking an antibiotic, inhibitors were detected in 80.5%. This test may help to explain culture negative urine samples from symptomatic patients, and could help elucidate treatment failures and the epidemiology of antibiotic resistance.
