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PA for the win!

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Good for us, bad for medical professionals in general. Now every one who has any sort of cough is going to want a "swab" and antibiotics. We should just remember to evaluate each patient, and take both the written record and the patients story with a grain of salt.


Not getting the antibiotics until proven necessary I can see, but bypassing such a simple test as a C&S in place of CXR's CT's, MRI's etc is not smart medicine in my opinion. I agree, every case should be evaluated individually, but I will admit I have seen a change over the years where providers used to order C&S's for URI sx at the initial visit, & now there seems to be a huge reluctance to do so.

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Great story from a PA angle


Docs refer out to multiple specialists, thousands upon thousands of dollars in testing....

PA nails it with cheap lab testing.


So....isn't the argument that PAs "don't know what we don't know", and refer out for everythin out of ignorance?

And docs have the lengthy training to keep them from avoiding unecessary, dangerous, invasive and expensive procedures?


Major ups to this PA. STRONG work......

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I dont agree that this was a "classic" case of pertussis. The only thing "classic" about it was the fact that the audio recording that the PA heard in the ER clearly revealed a staccato-type cough.


If you guys were in the ER and didnt get to hear the cough but you heard that the paramedics gave him some albuterol and his respiratory difficulties improved, wouldnt that sway you at least a little bit away from pertussis and more towards reactive airways disease? While it is true that beta 2 agonists can appear to give mild symptomatic relief even when there is no asthma, I think that muddies the waters just enough to not label this as a "classic" case.


A "classic" case also would involve sick contacts at home or other CLOSE relationships, not just the generic sick kids at school type of thing. There was a study that came out in JAMA a few years back showing that about 80% of proven cases of pertussis had at least one family member with nearly identical symptoms as the patient.

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