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Pneumonia, Adult, Emergency Medicine

Jason C. Imperato Reviewed 06/2017
 


Basics

Description

  • Epidemiology:

    • 7th leading cause of death and leading cause from infectious disease in US

  • Highest mortality in elderly and patients with the following coexisting conditions:

    • Chronic hear...

Diagnosis

Signs and Symptoms

History

  • Typical:

    • Acute onset

    • Fever

    • Chills

    • Rigors

    • Cough

    • Purulent sputum

    • Shortness of breath

    • Pleuritic chest pain

  • Atypical:

    • Subacute onset

    • Viral prodrome

    • Nonproductive cough

    • Low-grade feve...

Treatment

Pre-Hospital

  • IV access

  • Supplemental oxygen

  • Cardiac monitor

  • Consider inhaled bronchodilators.

  • Consider endotracheal intubation in cases of severe respiratory distress.

Initial Stabilization/Therapy

  • ...

Follow-Up

Disposition

Admission Criteria

  • Based on severity of illness, coexisting conditions, ability of home care, and follow-up

  • Clinical decision-making rules may aid in stratifying patients but should...

Pearls and Pitfalls

  • Delayed initiation of antibiotics in ill-appearing patients

  • Failure to recognize pneumonia in patients assumed to have exacerbations of underlying lung conditions

  • Failure to question...

Additional Reading

  • Mandell  LA, Wunderink  RG, Anzueto  A, et al. Infectious Disease Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia...

Codes

ICD9

  • 481 Pneumococcal pneumonia [Streptococcus pneumoniae pneumonia]

  • 486 Pneumonia, organism unspecified

  • 507.0 Pneumonitis due to inhalation of food or vomitus

  • 997.31 Ventilator associated pneumonia

  • ...

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