title: Do peripheral blood cultures taken in the emergency department influence clinical management?
abstract: BACKGROUND
  Blood cultures are routinely used to investigate suspected sepsis in the emergency department despite several studies showing their limited influence on patient management.
  
  
  OBJECTIVE
  To quantify the use and clinical relevance of blood cultures obtained in the emergency department.
  
  
  METHODS
  A retrospective study of blood cultures taken in the emergency department between 1 January 2003 and 31 December 2004. Microbiology results and patients' records were reviewed to determine the influence of positive cultures on subsequent patient management.
  
  
  RESULTS
  2213 blood cultures were taken in the emergency department over the study period. 132 (6%) yielded a positive result. Three positive cultures had incomplete information. Of the remaining 129 positive cultures, 30 (1.4% of all cultures) were "true positives" and 4 (0.18%) influenced subsequent patient management.
  
  
  CONCLUSIONS
  Blood cultures taken in our emergency department (Southern General Hospital, Glasgow, UK) rarely yield bacterial growth, and over 2 years only four cultures seemed to directly influence patient management. Better guidelines are required for targeted use of blood cultures in the emergency department.
authors.affiliation: Emergency Department, Southern General Hospital, 1345 Govan Road, Glasgow G51 4TF, UK. phil.munro@sgh.scot.nhs.uk
authors.forename: Philip T
authors.initials: PT
authors.lastname: Munro
authors.forename: Neil
authors.initials: N
authors.lastname: Howie
authors.forename: Jan F
authors.initials: JF
authors.lastname: Gerstenmaier
mesh_terms: D016470:Bacteremia / Q000175:diagnosis* / Q000382:microbiology; D001431:Bacteriological Techniques / Q000706:statistics & numerical data; D001800:Blood Specimen Collection / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital; D006801:Humans; D011364:Professional Practice; D012189:Retrospective Studies; D012606:Scotland; D019564:Unnecessary Procedures