Empyema

Empyema

Etiology
1. Prophylaxis
  1. Prophylactic use of antibiotics does not reduce the incidence of empyema (Heydari, Hessami, Setayeshi, & Sajadifar, 2013)
2. Risk Factors
3. PUS
4. Empyema
Pathophysiology
1. Complications
2. Classically empyema has three stages defined as exudative stage, fibrinopurulent stage, and organisational stage (BMJ publishing group, 2016b).
  1. First stage: Exudative Stage
    1. Exudative stage - sterile pleural fluid builds up in pleural space due to inflamation and increased permeability in the visceral pleura (BMJ publishing group, 2016b)
  2. Second Stage: Fibrinopurulent Stage
    1. Organisational stage - dense fibrinous connections form that restrict lung expansion (BMJ publishing group, 2016b)
  3. Third Stage: Organisational Stage
    1. Fibrinopurulent stage - bacteria invade the pleural space, fibrin is deposited on pleural membranes and can adhere between the visceral and parietal pleural membranes (BMJ publishing group, 2016b)
Epidemiology
1. Community acquired pneumonia has an incidence of 8-15/1000 per year of which up to 57% develop parapneumonic effusions and up to 10% of those develop into empyema (BMJ publishing group, 2016a),
2. More common in men than women ratio of 2:1(BMJ publishing group, 2016a)
3. more common in elderly than children (BMJ publishing group, 2016a)
Nursing Assessment
1. Assess Patient Knowledge level
2. Auscultation
Treatment
1. Medications
  1. Antibiotics
2. Management
  1. Patient Teaching
Diagnosis
1. Signs and Symptoms
2. Tests
3. Chest X-Ray

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	Created by Andrew Gilroy about 7 years ago