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1981. Guidelines for evaluation and management of urticaria in adults and children

of evidence III). A meta-analysis of therapeutic trials for Helicobacter pylori found that resolution of chronic urticaria was more likely when antibiotic therapy was successful than when it was not (Quality of evidence I, Strength of recommendation B). 6 There is no stat- istical association between malignancy and urticaria 7 (Quality of evidence II-ii) although individual case reports have been published. Appropriate investigations The diagnosis of urticaria is primarily clinical. 8 Any investi- gations (...) there is prolongation of the Q-T interval. It should not be taken concurrently with drugs that inhibit hepatic metabolism via cytochrome P450 (includ- ing macrolide antibiotics and imidazole antifungals) and with drugs that have potential arrythmic properties (including tricy- clic antidepressants, such as doxepin). Cetirizine has the short- est time to attain maximum concentration, which may be an advantage where rapid availability is clinically important. Des- loratadine has the longest elimination T½ at 27 h

2007 British Association of Dermatologists

1982. Guideline for the Screening and Treatment of Retinopathy of Prematurity

the treatment? After treatment your baby may need to be given some antibiotic and steroid eye drops to prevent infection and reduce swelling. An appointment will be made for an eye examination about a week later when the ophthalmologist will check if the treatment has stopped the abnormal blood vessels developing. In most babies one treatment is effective but sometimes a second treatment will be needed around 2 to 3 weeks later. Are there any side-effects from the treatment? ROP treatment is a surgical

2008 British Association of Perinatal Medicine

1983. Intermediate care - Hospital at Home in COPD

there is impairment of consciousness, confusion, acidosis, serious co-morbidity or inadequate social support. 2. After suitability for HaH is confirmed by assessment in hospital, a treatment package is prescribed which includes antibiotics, steroids, nebulised bronchodilators and oxy- gen if necessary. 3. Home care should be delivered by specialist respiratory nurses/physiotherapists or in generic teams by district nurses. 4. For most hospitals the preferred model of HaH should be early supported discharge (ESD (...) that the airways of a proportion of patients with stable COPD are chronically colonised with bacteria and consequently an organism cultured during an exacerbation may not be causal. 29 30 Similarly, the spectrum of antibiotic-responsive organisms commonly causing exacerbations is well known without the need for culture. 18 Consequently, the NICE guide- line 2 recommends routine sputum culture only for patients admitted to hospital and when the sputum is purulent. Recommendation N (R10) Routine sputum culture

2007 British Thoracic Society

1984. Infection control in anaesthesia

in the transfer of potential pathogens and a decrease in the incidence of preventable HCAI [4]. Despiteconsistentadvice,staffoftenneglecthandhygiene when caring for patients. At the start of every session, and when visibly soiled or potentially contaminated, hands must be washed with liquid soap and water. When there is no soiling, the Hand Hygiene Liaison Group advocates that staff should use an antimicrobial hand rub between patients or activities [5] as this is effective and quicker. It is vital to ensure (...) that the whole hand and ?ngers (particularly the tips), are exposed to the hand rub. Antimicrobial hand rub is not effective in preventing cross infection with Clostridium dif?cile. Trusts must ensure that sinks, soap and antimicrobial hand rubs are conveniently placed to encourage regular use. Watches and jewellery (including dress rings and wrist adornments) must be removed at the beginning of each clinical session, before regular hand decontamina- tion begins. Cuts and abrasions must be covered

2008 Association of Anaesthetists of GB and Ireland

1985. Specific Treatment Options - chronic obstructive pulmonary disease

adjusted accordingly. In the short time that a patient is in ambulance care hypoxia presents a much greater risk than hypercapnia in most cases. Whilst blood gas levels are important to continuing long term care of the patient, a lack of oxygen will prove fatal far more rapidly in the acute setting than changes in CO2 levels which alter more slowly. Use of systemic corticosteroids as advocated in asthma is of no proven bene?t in acute exacerbations of COPD. A course of oral steroids and/or antibiotics

2007 Joint Royal Colleges Ambulance Liaison Committee

1986. Specific Treatment Options - meningococcal septicaemia

of patient. Repeat assessment and further management of ABCs as necessary en route. RISK OF INFECTION TO AMBULANCE PERSONNEL Meningococcal bacteria are very fragile and do not survive outside the nose and throat. Public health guidelines recommend preventative antibiotics only for health workers whose mouth or nose is directly exposed to large particle droplets / secretions from the respiratory tract of a patient with meningococcal disease. This type of exposure is unlikely to occur unless Ambulance (...) Clinicians are in close proximity to patients, for example, when undertaking airway management or inhaling droplets when patients cough or sneeze. When a case of meningococcal disease is con?rmed, the public health Doctor will ensure that antibiotics are offered to any contacts of the case whose exposure puts them at increased risk of infection. Key Points – Meningococcal septicaemia ? Meningococcal disease is the leading infectious cause of death in children and young adults and can kill a healthy

2007 Joint Royal Colleges Ambulance Liaison Committee

1987. Drugs - Benzylpenicillin (Penicillin g)

Drugs - Benzylpenicillin (Penicillin g) Benzylpenicillin (Penicillin G) BPN Drugs October 2006 Page 1 of 2 Drugs PRESENTATION Ampoule containing 600 milligrams of benzylpenicillin as powder. ACTIONS Antibiotic active against a range of bacteria. DOSAGE AND ADMINISTRATION Administer en-route to hospital (unless already administered by GP etc). Administer by slow IV injection. If it is not possible to gain rapid vascular access, the drug should be given by the IM route, as detailed below (...) VOLUME <1 year 300 milligrams 5.0ml 1-<9 years 600 milligrams 10.0ml 9 years – adult 1.2 grams (2 vials) 20.0ml Concentration – 600 milligrams dissolved in 9.6ml water for injections. AGE DOSE VOLUME <1 year 300 milligrams 1.0ml 1-<9 years 600 milligrams 2.0ml 9 years – adult 1.2 grams (2 vials) 4.0ml Concentration – 600 milligrams dissolved in 1.6ml water for injections.ADDITIONAL INFORMATION Penicillin Allergy Antibiotic allergy – This will be a very dif?cult judgement for ambulance staff as many

2007 Joint Royal Colleges Ambulance Liaison Committee

1989. Evidence-Based Guidelines for the Classification and Management of Drug Induced Phototoxicity

of phototoxicity in dark-skinned individuals. 8. Susceptibility to photosensitivity can persist for several months after cessation of a photoactive drug. Table 1. Major patterns of cutaneous phototoxicity Skin reactions Photosensitisers Prickling or burning during exposure immediate erythema; oedema or urticaria with higher doses; sometimes delayed erythema or hyperpigmentation Photofrin; amiodarone; chlorpromazine Exaggerated sunburn Fluoroquinolone antibiotics; chlorpromazine; amiodarone; thiazide diuretics (...) ; quinine; demethylchlortetracycline and other tetracyclines Late onset erythema; blisters with slightly higher doses; hyperpigmentation only with low doses Psoralens Increased skin fragility with blisters from trauma (pseudoporphyria) Nalidixic acid; frusemide; tetracycline; naproxen; amiodarone; fluoroquinolone antibiotics Photoexposed site telangiectasia Calcium channel antagonists From: Ferguson J. Photosensitivity due to drugs. Photoderm Photoimmunol Photomed 2002, 18, 262-269. Diagnostic

2007 European Dermatology Forum

1992. Nursing Care of Dyspnea:The 6th Vital Sign in Individuals with Chronic Obstructive Pulmonary Disease

cessation modalities during hospitalization for acute exacerbation. Medications 3.0 Nurses should provide appropriate administration of the following pharmacological agents as prescribed: ¦ Bronchodilators (Level of Evidence = 1b) ? Beta 2 Agonists ? Anticholinergics ? Methylxanthines ¦ Oxygen (Level of Evidence = 1b) ¦ Corticosteroids (Level of Evidence = 1b) ¦ Antibiotics (Level of Evidence = 1a) ¦ Psychotropics (Level of Evidence = IV) ¦ Opioids (Level of Evidence = IV) 3.1 Nurses will assess

2005 Registered Nurses' Association of Ontario

1994. Assessment and Management of Venous Leg Ulcers

pain; increasing erythema of surrounding skin; purulent exudate; rapid increase in ulcer size). 31. Do not use topical antiseptics to reduce bacteria in wound tissue, B e.g., povidone iodine, iodophor, sodium hypochlorite, hydrogen peroxide, or acetic acid. 32. Topical antibiotics and antibacterial agents are frequent sensitizers and B should be avoided. F. COMPRESSION 33. The treatment of choice for clinical venous ulceration uncomplicated A by other factors, is graduated compression bandaging (...) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .101 Appendix G – Pain Assessment Tools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .103 Appendix H – Cleansing Agents and Their Associated Toxicities . . . . . . . . . . . . . . . . . .106 Appendix I – Potential Allergens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .107 Appendix J – Topical Antimicrobial Agents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .108 Appendix K – Classes of Compression Bandages

2004 Registered Nurses' Association of Ontario

1995. Inhalation devices and propellants

deposition of nebulised pentamidine in children. Thorax 1993 ; 48 : 220 -6. 32. Mukhopadhyay S, Staddon GE, Estman C, Palmer M, Rhys Davies E, Carswell F. The quantitative distribution of nebulized antibiotics in the lung in cystic fibrosis. Respir Med 1994 ; 88 : 203 -11. 33. Finlay WH, Stapleton KW, Zuberbuhler P. Errors in regional lung deposition predictions of nebulized salbutamol sulphate due to neglect or partial inclusion of hygroscopic effects. Int J Pharm 1997 ; 149 : 63 -72. 34. Phipps PR

1999 CPG Infobase

1996. Prevention of group B streptococcal infection in newborns

given on the basis of risk factors only Potential benefits • Prevention of GBS colonization and early-onset infection in neonates Potential harms • Increased incidence of GBS strains resistant to erythromycin (reported rates ranging from 3.2% to 16.0%) and clindamycin (reported rates ranging from 2.5% to 15%) , , • Increased incidence of neonatal sepsis due to ampicillin-resistant organisms other than GBS (possibly related to widespread use of antepartum and intrapartum antibiotics (...) of early-onset infection in the control groups were 7% and 0.1% respectively). (In view of statistically significant heterogeneity [ p = 0.0062], the results of the 2 studies were not combined.) Thus, a much larger proportion of pregnant women will receive antibiotics if universal screening for GBS colonization and IPC is adopted as a preventive strategy than if universal screening and selective IPC given on the basis of risk factors is adopted. The point estimates for effectiveness for the different

2002 CPG Infobase

1997. Guidelines for the Management of Colorectal Cancer

-disciplinary team 26 iii) Surgical specialisation 27 Process 28 i) Preparation for surgery 28 a) Informed consent 29 b) Preparation for stoma formation 30 c) Cross-matching 30 d) Bowel preparation 30 e) Thrombo-embolism prophylaxis 31 f) Antibiotic prophylaxis 31 g) Enhanced recovery 32 ii) Rates of curative resection 32 iii) Definition of Rectal Tumour 32 iv) Surgical technique 33 a) Resection 33 b) Anastomosis 34 v) Rates of permanent stoma formation 35 vi) Local excision 35 vii) Laparoscopic surgery 36

2007 Association of Coloproctology of Great Britain and Ireland

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