I have recently been asked a number of questions via the website and thought it would be useful to share the answers to a wider audience. They are related to the management of urinary tract infection (UTI) in an elderly patient.
I understand the patient was an 89 year old lady who presented with fever, incontinence and pain on passing urine; she was also confused and had signs of sepsis with tachycardia and hypotension. She was diagnosed with a UTI and E. coil was grown from a urine sample. She was started on IV Co-amoxiclav. Her ongoing incontinence lead to the skin of her perineum and sacrum starting to become inflamed and she was in danger of falling and hurting herself due to the frequent need to get out of bed to use the toilet. The junior doctor started IV antibiotics and in order to protect her skin and provide short-term support for her incontinence inserted a urinary catheter. The junior doctor was then told off for 1) giving her IV antibiotics instead of orals and 2) inserting a catheter in a patient with urosepsis.
I understand the patient was an 89 year old lady who presented with fever, incontinence and pain on passing urine; she was also confused and had signs of sepsis with tachycardia and hypotension. She was diagnosed with a UTI and E. coil was grown from a urine sample. She was started on IV Co-amoxiclav. Her ongoing incontinence lead to the skin of her perineum and sacrum starting to become inflamed and she was in danger of falling and hurting herself due to the frequent need to get out of bed to use the toilet. The junior doctor started IV antibiotics and in order to protect her skin and provide short-term support for her incontinence inserted a urinary catheter. The junior doctor was then told off for 1) giving her IV antibiotics instead of orals and 2) inserting a catheter in a patient with urosepsis.
Junior Doctors are definitely looking younger but at least he is bare below the elbows!
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