We often worry about patients developing rhabdomyolysis and consequently developing AKI. However, there is much debate and little consistency in the published data, over how to diagnose and who needs admission to treat. So its important to consider both clinical context along with laboratory values
Category: Urology
Necrotising Fasciitis
Necrotising fasciitis (NF) is a rare but serious bacterial infection that affects the soft tissue and fascia (Fournier gangrene, is NF affecting the perineum). In many cases NF progresses rapidly and early recognition and treatment is vital to halt progress. The mainstay of treatment is IV antibiotics and aggressive surgical debridement. Any delay increased the amount of tissue loss as well as the mortality. Read more
Urinary Catheterisation in ED
Pre-catheterisation
- Confirm appropriate indication
- Relief of acute or chronic urinary retention
- Need for accurate measurements of urinary output in critically ill patients
- Patient requires prolonged immobilisation (e.g potentially unstable traumatic injury)
- To improve comfort for end of life care
- Bladder scan & document result
- Appropriate consent from patient
Urinary Retention
A common problem which affects 1 in 10 men between 70-79yrs and 1 in 3 men 80-89yrs (10M:F)
Signs/Symptoms
- Unable to pass urine (may be passing small amounts overflow)
- Desire to pass urine (reduced in neurological causes e.g. cauda equine)
- Suprapubic & loin pain (may not be present in chronic or neurological causes)
- Palpable bladder on examination
Be #urosceptical
Ditch the Dipstick – for patients >65Yrs or Catheterised!
Approx. 50% of over 65’s and most of those with catheters have asymptomatic bacteriuria. The patient will not benefit from treatment and often gives us premature closure (i.e. we blame a fictitious UTI for the patients symptoms and stop thinking). Read more
