1. Which patients with neutropenic fever do you consider for outpatient management?
2. Which patients with community-acquired pneumonia do you admit?
3. Which patients with influenza do you treat with oseltamivir?
4. Which adult patients getting worked up for a urinary tract infection do you send a urine culture on?
1. MASCC score ’em. Though in reality, I’m rarely discharging, and only if their onco is ok with it. Otherwise, if they’re low risk via MASCC, I’m giving PO meds and placing in obs.
2. I tend to follow PORT. The borderline class 3’s I try in obs first. If barriers to care, obs vs admit, case dependent. (ie, alcoholics & homeless get admitted)
3. ICU patients. Some admits as I’m forced by admin to give it. Outpatient? absolutely not.
4. Bouncebacks. Admits / obs. Elderly. Infected stones. SNF patients. Urosepsis. Those with multiple allergies.