Community Acquired Pneumonia in Adults

Author:  Jason Lee / Editors: Jason Kendall / Reviewer: Jon Bailey, Kathryn Blackmore / Codes: / Published: 21/11/2022

This session covers community-acquired pneumonia (CAP), which is by far the commonest form of pneumonia seen in the Emergency Department (ED).

After completing this session you will be able to:

  • Risk stratify patients using the CURB-65 scoring system
  • Differentiate patients requiring admission from those that can be discharged from the Emergency Department
  • Determine which investigations are of value in individual presentations of pneumonia
  • Employ appropriate treatments according to the severity of the infection
  • Identify patients that require intensive care or high dependency input
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References:

  1. Lim WS, Baudouin SV, George RC, Hill AT, Jamieson C, Le Jeune I, Macfarlane JT, Read RC, Roberts HJ, Levy ML, Wani M, Woodhead MA; Pneumonia Guidelines Committee of the BTS Standards of Care Committee. BTS guidelines for the management of community acquired pneumonia in adults: update 2009. Thorax. 2009 Oct;64 Suppl 3:iii1-55. doi: 10.1136/thx.2009.121434.
  2. National Institute for Health and Care Excellence. Pneumonia in adults: diagnosis and management. NICE [CG191] Last updated: 07 July 2022.
  3. British Thoracic Society. Annotated BTS Guideline for the management of CAP in adults. Summary of recommendations (2015).
  4. Lim WS, Smith DL, Wise MP, Welham SA; British Thoracic Society. British Thoracic Society community acquired pneumonia guideline and the NICE pneumonia guideline: how they fit together. Thorax. 2015 Jul;70(7):698-700.
  5. Guest JF, Morris A. Community-acquired pneumonia: the annual cost to the National Health Service in the UK. Eur Respir J. 1997 Jul;10(7):1530-4.
  6. ODriscoll BR, Howard LS, Davison AG. BTS guideline for emergency oxygen use in adult patients. Thorax 2008;63:vi1-vi68.
  7. Campbell SG, Marrie TJ, et al. Utility of blood cultures in the management of adults with community acquired pneumonia discharged from the emergency department. Emerg Med J. 2003;20(6):521-523
  8. Campbell SG, Marrie TJ, et al. The contribution of blood cultures to the clinical management of adult patients admitted to the hospital with community-acquired pneumonia: a prospective observational study. Chest. 2003;123(4):1142-1150.
  9. Hodkinson HM. Evaluation of a mental test score for assessment of mental impairment in the elderly. Age Ageing. 1972 Nov;1(4):233-8. doi: 10.1093/ageing/1.4.233..
  10. Lim WS, van der Eerden MM, et al. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax. 2003 May;58(5):377-82.
  11. Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, Peterson E, Tomlanovich M; Early Goal-Directed Therapy Collaborative Group. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001 Nov 8;345(19):1368-77.
  12. Shapiro NI, Howell MD, Talmor D, et al. Serum lactate as a predictor of mortality in emergency department patients with infection. Ann Emerg Med. 2005 May;45(5):524-8.

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