[quote=nightngale1998]Quote:
what are the Centor criteria for empirically treating for Strep throat?

The Centor Score is a predictor measurement of the likelihood of a + strep diagnosis. Did I get that right?

absolutely correct. specifically, the Centor criteria are:

1) hx of fever (usually > 101)
2) no cough
3) cervical chain adenophathy
4) exudative pharyngitis

I know one ER doc who will treat a pt presumptively as having Strep throat if they meet the criteria. Who hasn't seen rapid strep screens be negative only to have the culture turn out positive?

This is the same concept as using the Ottawa ankle rules to determine the necesity for ankle films. Speaking of the Ottowa ankle rules, what are they, specifically?

Originally Posted by thanatos

speaking of strep throat, why is important to know if a pt who is presenting like an appy recently had strep throat?

bump...

isn't anyone going to take a stab at this one?

Notice how I smoothed over that one! No, I do not know. And... I looked it up in the ENPC and could not find it (although it may be there). So...

(quote) why is important to know if a pt who is presenting like an appy recently had strep throat?

Oh and an FYI, please no bumping, it is not really allowed on the board (long story that is old). PM me if you you any Q's regarding that.

I have no idea about any of this but I am finding this thread very interesting. Keep them comming!

Posted by nightngale1998: Zen: increased anxiety between 3-5PM; could that be from the increased Catecholamenes?

Nope, 3-5pm is the time that ki is the strongest in the Bladder meridian. One of the psychological aspects of this meridian is anxiety/fear.

Heh Zen: That's not fair! That is not a Nursing Question It is good to know though! I have long been an advocate of Acupuncture and Holistic Medicine so thanks for reminding me of the Eastern Influences in Health Care.


night

Originally Posted by thanatos

This is the same concept as using the Ottawa ankle rules to determine the necesity for ankle films. Speaking of the Ottowa ankle rules, what are they, specifically?

Ottawa Ankle Rules
Unable to bear weight immediately and in ED.
Tender on lateral malleolar tip or posterior aspect of lateral malleolus.
Tender on medial malleolar tip or posterior aspect of medial malleolus.

Answer yes to any = x-ray.

Ottawa Foot Rules
Unable to bear wieght imediately and in ED
Tender over navicular bone
Tender at 5th metatarsal base

Answer yes to any = x-ray

Ottawa Knee Rules
Unable to bear weight immediately and in the ED
Age 55 years +
Isolated patellar tenderness
Fibular head tenderness
Inability to flex > 90 degrees

Answer yes to anyy = x-ray

Here is a stumper for you.

What are the NEXUS criteria for avoiding c-spine x-rays?

Originally Posted by thanatos

bump...

isn't anyone going to take a stab at this one?

Hmmm, specifically strep throat or just sore throat. Mono can cause sore throat and abdominal pain mimicing appy.

Originally Posted by treddrn

Speaking of strep throat........how come nurses are not educating their patients to toss the toothbrush? I thought the nurse was to educate their patient. I have had a lady to come to the ER 5+ times for strep throat and when I was discharging her, I advised her to toss the toothbrush and go to the dollar store and buy the pack that has a few in a box for a dollar. I told her that after she used one toothbrush that day that she needed to toss it in the trash and the next day use a new one. Then after a few days she can get a more suitable toothbrush that she would like. She told me that no one has ever told her that. Well, I haven't seen her and it has been several weeks. Maybe I am a bit extreme with using a different toothbrush for a few days but strep throat is not a comfortable feeling and there are risks involved. I am a new ER nurse and I have found out that no one in my ER educates about tossing the toothbrush. So far, my advise has been very successful. No one that has followed my advised has had to return for reoccurring strep throat.

My plan was to just read this thread to learn from it. But I have a suggestion for you. Why don't you post this one out in General Nursing Discussions.
For years we have told pts to put their tooth brush in Listerine to soak (as opposed to replacing it) but I recently saw something someplace claiming Listerine doesn't do much for that elusive 1% of germs.
I don't just want to take your post and move it around, but thought you might do it. May make great conversation to know how other nurses have helped their pts prevent recurrence.