Pneumonia Lecture Flashcards
3 types of pneumonia
CAP
HCAP
Aspiration
CRB-65 Score:
1pt for confusion (delirium)
1 pt for RR>30
1 pt for BP< 90 systolic or 60 diastolic
Score 0-1: manage at home
Score >1: inpatient management
True or False…
A pneumonia pt with hypoxia is an automatic admission
TRUE
Empiric abx
O2 if sats <90%
Nebulized inhalation tx (albuterol Q2hrs, duoneb Q4-6 hrs)
Pneumonia tx
Frequent vitals (fever, BP, HR, RR) Daily labs (CBC, BMP, blood cultures) Repeat imaging is NOT necessary if clinical improvement is seen
Monitoring of pneumonia pt
If pneumonia pt is not improving, what image can you get to rule out empyema or lung abscess
chest CT
pneumonia…
within 48 hrs after admission
48-72 hrs after endotracheal intubation
IV, wound care, IV chemo in prior 30 days
Health care associated pneumonia (HCAP)
1 or more…
- abx in last 90 days
- current hospitalization >5 days
- high freq abx resistance in community
- immunosuppressive dz and or tx
- severe septic shock
assume multi-drug resistant (MDR) pneumonia
Ceftriaxone
Levaquin or Avelox
..for MDR risk or non MDR risk pts?
Non MDR risk pts
“triple abx therapy” IV
- zosyn
- fluoroquinolone
- vanco
for MDR risk or non MDR risk pts?
MDR risk pts!
HCAP tx is for a minimum of…
7 days
If pt is imporving after IV therapy for 48-72 hours, what can you do?
switch to PO abx
What abx should you give for aspiration pneumonia?
Clindamycin IV
True or false…
For aspiration pneumonia, NPO until speech therapy consult
TRUE