Do peripheral blood cultures taken in the emergency department influence clinical management?
BACKGROUND
Blood cultures are routinely used to investigate suspected sepsis in the emergency department despite several studies demonstrating 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 patient 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 cases 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 rarely yield bacterial growth and over 2 years, only four seemed to directly influence patient management. Better guidelines are required for targeted use of blood cultures in the emergency department.
Howie
Neil
N
Emergency Department, Southern General Hospital, 1345 Govan Road, Glasgow, G51 4TF UK.
Gerstenmaier
Jan F
JF
Munro
Philip T
PT
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