calipa Posted February 8, 2014 Share Posted February 8, 2014 When you transition an admitted patient from IV to oral steroids for discharge after acute exacerbation of COPD, how soon can you discharge after transitioning? Link to comment Share on other sites More sharing options...
BARONEUS Posted February 9, 2014 Share Posted February 9, 2014 I believe the discharge is based more on the patient's condition (white count, SpO2 vs O2 level, breath sounds, level of DOE, etc.). I've even seen docs start the oral taper while they're still admitted. Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted February 9, 2014 Share Posted February 9, 2014 Not sure the WBC is that great of an indicator since steroid therapy can cause leukocytosis in and of itself. I'm not sure that I see the benefit of hospitalization IF the justification was for IV steroids without other associated RT modalities. Steroids don't work any faster with one route of administration versus another. Check out the Medscape posted studies from '08 to present day. I have asked students for years about a patient coming into the ED that needs antihistamines, analgesics, steroids, and anti-emetics. Which one of the four will not work any faster via IV route versus p.o.? The answer are the steroids but since you've going to obtain IV access for the others you just go ahead and give the steroids via that route as well. Link to comment Share on other sites More sharing options...
BARONEUS Posted February 9, 2014 Share Posted February 9, 2014 Not sure the WBC is that great of an indicator since steroid therapy can cause leukocytosis in and of itself. I apologize if I have mislead anyone with my vague, reckless jargon. Please excuse my above statement of WBC, and consider CBC/diff instead. Link to comment Share on other sites More sharing options...
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