Porfirio

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What do you all think is going to happen once we start using the COVID vaccines? My understanding is the plan is to vaccinate the high risk (including elderly nursing home patients).

After these elderly nursing home patients get the vaccine and start popping fevers (?from the vaccine), you think we are going to get a rush of new patients to triage and explain fevers? I feel like this is going to be a rough time too.

Nursing Home Dementia + fever = more confused than normal with fever better send them to the ER

My own personal hell would be all the “admission required LPs.” I might just say f*ck it and walk away from EM for awhile.

You all thought about this future?
 

skougess

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How many of them get fevers with the vaccine? Do we actually have any idea or are we just speculating? I would guess it would be a very very small amount.
 

JacobMcCandles

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Are you routinely doing LPs on the febrile demented patient now? I bet you end up doing the same number pre-vaccine as you do post-vaccine.
 
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GeneralVeers

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Is doing LPs on demented nursing home patients with fever common practice? We almost never do these and I don't know any doctors who do. Almost always you can find a UTI in the female patients.
 
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RoyBasch

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I would much sooner do a CT abdomen pelvis on an apparent fever without a source + altered elderly patient before an LP.
 
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thegenius

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Yeah....if I had to do an LP on an 82 yo demented patient I would poke once, claim I couldn't get it, and admit.
 
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gamerEMdoc

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If I'm gonna LP an elderly febrile patient, its because they are legit altered or excessively somnolent, not because "they are a little more confused from their baseline dementia". It's a rare occurence.

I'm sure some people will get low grade fevers with the vaccine, but nursing homes are hotbeds for covid right now, and they aren't sending them in unless they are in resp distress or legit ill anymore bc we have to send them right back anyways. So I highly doubt this is going to do much to our already overwhelmed healthcare system other than make things better in the longrun.
 
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