EM Cases · Community-acquired pneumonia
Severe CAP with sepsis — resus station
ACEM Fellowship resus OSCE on CURB-65, Hour-1 sepsis bundle, and severity-directed antibiotics.
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Target exams
ACEMFRCEMABEMFRCPCCCFPEMEBEEM
Prompt
An elderly patient with multilobar pneumonia, hypotension and high lactate.
Station brief
Format. Clinical-management (resus) station, 11 minutes total — 4 minutes reading, 7 minutes active assessment. You are the Emergency Medicine consultant leading care.
Candidate instructions. Manage the patient from handover. State actions and reasoning aloud. The examiner plays the nursing and specialty team.[2]
References5ShowHide
- [1]Fine MJ et al. A prediction rule to identify low-risk patients with community-acquired pneumonia. NEJM, 1997.PMID 8995086
- [2]Lim WS et al. Defining community acquired pneumonia severity on presentation to hospital (CURB-65). Thorax, 2003.PMID 12728155
- [3]Metlay JP, Waterer GW, Long AC, et al. Diagnosis and treatment of adults with community-acquired pneumonia. An official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med, 2019.PMID 31573350
- [4]National Institute for Health and Care Excellence Pneumonia in adults: diagnosis and management (CG191) NICE, 2014.Source
- [5]Kumar A, Roberts D, Wood KE, et al. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med, 2006.PMID 16625125