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121. Clinical guide for the management of critical care for adults with COVID-19 during the Coronavirus pandemic

therapies should only be administered within the context of a nationally approved trial. COVID-19 related clinical trials should be supported to rapidly develop an evidence base for this new disease. Routine antibiotics ? Routine antibiotics are not recommended for uncomplicated COVID-19. Treatment of other conditions in the context of COVID-19 ? Careful attention to antimicrobial stewardship: antibiotics should be considered if there is suspected bacterial super-infection. ? Take care not to neglect (...) antibiotics 8 Treatment of other conditions in the context of COVID-19 8 Impact of non-steroidal anti-inflammatory drugs (NSAIDs), ACE-inhibitors and ARBs on COVID-19 9 4 Clinical decision-making 9 General comments 9 Referral and admission to intensive care or palliative care 9 Treatment decisions 10 5 Management of respiratory failure 10 Oxygen therapy 10 High flow nasal oxygen 11 CPAP and NIV 11 Intubation 12 Mechanical ventilation 12 Management of early (pneumonitis) phase 14 Management of later

2020 ICM Anaesthesia COVID-19

122. Diagnosis and management of sepsis in the paediatric patient

: recognition of changes in clinical condition and vital signs, such as fever, tachycardia, and changes in peripheral perfusion, which should raise concern for sepsis; initial stabilization of airway, breathing, and circulation; timely administration of empiric antimicrobial therapy; use of fluid boluses and vasoactive medications; and specific considerations in patients with underlying medical conditions, such as the use of corticosteroids for possible adrenal insufficiency due to hypothalamic-adrenal

2020 Canadian Paediatric Society

124. Paediatric inflammatory multisystem syndrome temporally associated with COVID-19

screening investigations ( ). PIMS/MIS-C should also be considered in patients with ≥5 days of unexplained fever. Critically ill individuals should receive broad-spectrum antibiotic coverage pending results from their microbiological and hyperinflammatory work-up and be admitted to an ICU for inotropic support and mechanical ventilation, as required. For hospitalized patients with moderate to severe end-organ dysfunction, multidisciplinary team involvement is advised. This team may include general (...) presenting with shock or shock-like states. Patients presenting with or developing hypotension, severe cardiac dysfunction (including elevated troponin, NT-proBNP, abnormal ECG), or other shock-like states (including GI or neurologic presentations) can deteriorate very quickly and require rapid, judicious fluid resuscitation, inotropic support, and intubation. Initial broad-spectrum antibiotics are recommended because symptoms overlap with severe bacterial infections. Emergent cardiology and critical

2020 Canadian Paediatric Society

126. Anaesthesia and critical care: guidance for Clinical Directors on preparations for a possible second surge in COVID-19

(VTE) prophylaxis and treatment. Venous thromboembolism (VTE) prophylaxis and treatment. Antibiotic treatment. Antibiotic treatment. Indications for Indications for dexamethasone dexamethasone. . Indications for Indications for remdesivir remdesivir. . Indications for and management of renal replacement therapy. Indications for and management of renal replacement therapy.21 September 2020 8 Tracheostomy timing and processes. Tracheostomy timing and processes

2020 ICM Anaesthesia COVID-19

128. Coronavirus (COVID-19) infection and pregnancy

infection and perform full sepsis-six screening and administer intravenous antibiotics when appropriate. • Consider bacterial infection if the white blood cell count is raised (lymphocytes usually normal or low with COVID-19) and commence antibiotics. • Women should be offered testing for COVID-19 if they meet the inpatient or community PHE criteria. o Current inpatient case criteria (correct as of 19 July 2020) are individuals who are being/are admitted to hospital with one of the following: - A loss

2020 Royal College of Obstetricians and Gynaecologists

129. Prostate Cancer Part 1: Diagnosis and Referral in Primary Care

by approximately 50%. For accurate interpretation relative to lab-reported aged-based ranges, adjust the reported result by a factor of 2. PSA testing should be avoided if the patient has signs or symptoms of acute prostatitis (e.g., dysuria, hematuria, pelvic/groin pain, fever/chills). Antibiotics should not be used in an attempt to lower PSA as this practice may be detrimental. Epidemiology Prostate cancer usually develops slowly. Many men with prostate cancer will not have clinical progression (i.e (...) , adjust the reported result by a factor of 2. 2. Other benign causes of LUTS Acute Prostatitis PSA testing should be avoided if the patient has signs or symptoms of acute prostatitis (e.g., dysuria, hematuria, pelvic/groin pain, fever/chills). Urinary Tract infections Refer to LUTS that are considered benign should be reconsidered when new or worsening symptoms occur. Note: In patients presenting with LUTS, but without signs of acute prostatitis, antibiotics should not be used in attempt to lower

2020 Clinical Practice Guidelines and Protocols in British Columbia

130. COVID-19: Guidance for the remobilisation of services within health and care settings

in the “UK Five-year Tackling Antimicrobial Resistance National Action Plan (2019-2024).” COVID-19: infection prevention and control guidance Uncontrolled if printed. 5 Contents 1. Explanation of the updates to infection prevention and control guidance 6 2. Introduction 7 2.1 Scope and purpose 7 3. Governance and responsibilities 9 4. Care pathways 10 4.1 Administration measures for the pathways 12 4.2 Community settings 14 4.3 Outpatient/primary/day care 14 5. Standard Infection Prevention Control

2020 ICM Anaesthesia COVID-19

131. NZSHS Syphilis in Pregnancy Guideline

Academy of Pediatrics. Syphilis. In: Red Book: 2018 Report of the Committee on Infectious Diseases, 31st ed, Kimberlin DW, Brady MT, Jackson MA, Long SS (Eds), American Academy of Pediatrics, Itasca, IL 2018. p.773 18. Clement ME, Okeke NL, Hicks CB. Treatment of syphilis: a systematic review. JAMA. 2014;312(18):1905–17. 19. Walker GJA. Antibiotics for syphilis diagnosed during pregnancy. Cochrane Database Syst Rev. 2001; (3):CD001143. Syphilis in Pregnancy Sept 2020 V1 28 20. Centers for Disease

2020 New Zealand Sexual Health Society

134. Clinical management of children admitted to hospital with suspected COVID-19

recommended in some adult papers, the following medical treatments are likely to have more side-effects than beneficial effects in children and are not routinely indicated for empiric treatment of COVID-19, but should be used if otherwise clinically indicated: bronchodilators, systemic steroids, antibiotics, antivirals, and diuretics. Despite emerging concern about Angiotensin Converting Enzyme (ACE) Inhibitors and non- steroidal anti-inflammatory drugs (NSAIDs), there is insufficient evidence (...) Injury Consensus Conference Group.18 Supportive medical care This section covers: admission, radiology, fluids, antipyretics, respiratory support, antibiotics, bronchodilators / treatment of children with asthma attacks, and liver dysfunction. Admission Not all children with COVID-19 require admission. Many people with confirmed COVID-19 may be managed at home, in line with Public Health England guidance. Radiology Chest x-rays and CT scans may reveal non-specific findings even in asymptomatic

2020 Royal College of Paediatrics and Child Health

135. Coronavirus (COVID-19) infection and pregnancy

infection, all women should be prescribed at least 10 days of prophylactic LMWH.’ This is consistent with recommendations already made elsewhere in previous versions of this document. 9 13.5.20 4.6 (Now 3.6): Changed statement ‘Consider bacterial infection if the white blood cell count is raised (lymphocytes usually normal or low with COVID-19) and commence antibiotics’ to ‘Bacterial infection is an important differential diagnosis to COVID-19 infection. We advise blood cultures and a low threshold (...) for antibiotics at presentation, with early review and rationalisation of antibiotics if COVID-19 is confirmed.’ 9 13.5.20 3.6: Statement added: ‘A woman with moderate or severe COVID symptoms who happens to be pregnant but with no immediate pregnancy issue should be cared for by the same multidisciplinary team as a non-pregnant woman with additional input from the maternity team. The labour ward should not be the default location for all pregnant women.’6 1. Introduction7 1. Introduction The following advice

2020 Royal College of Obstetricians and Gynaecologists

136. Assisted Vaginal Birth

degree angle initiated when the head is distending the perineum. [New 2020] Grade of recommendation: B Aftercare following assisted vaginal birth Should prophylactic antibiotics be given? A single prophylactic dose of intravenous amoxicillin and clavulanic acid should be recommended following assisted vaginal birth as it significantly reduces confirmed or suspected maternal infection compared to placebo. [New 2020] Grade of recommendation: A Good standards of hygiene and aseptic techniques

2020 Royal College of Obstetricians and Gynaecologists

137. Care of patients with liver disease during the COVID-19 pandemic: EASL-ESCMID position paper

injury with jaundice seem to be rare 39 Patients with decompensated cirrhosis should not be treated Consider risk of HBV reactivation 40 Methylprednisolone (steroids) Corticosteroids bind nuclear receptors to dampen proin?ammatory cytokines Mostly used in patients with septic shock Currently NOT recommended by WHO 41 The risk of other infections (e.g. SBP) and viral shedding may increase in patents with decompensated liver cirrhosis Consider antimicrobial prophylaxis Consider risk of HBV

2020 European Association for the Study of the Liver

138. Updated SOGC Committee Opinion – COVID-19 in Pregnancy

and discontinuation of precautions should be determined in accordance with Public Health Agency of Canada guidelines,(15) and provincial and territorial guidance. • Health care providers can consider empiric antibiotic therapy for superimposed bacterial pneumonia in women with confirmed COVID-19 infection or severe respiratory disease. First-line antibiotics are oral amoxicillin for stable patients and ceftriaxone for severe disease, based on general recommendations for the management of pneumonia. • For maternal

2020 Society of Obstetricians and Gynaecologists of Canada

139. COVID-19 - guidance for paediatric services

protective equipment should be worn, irrespective of whether the child has symptoms consistent with COVID-19 or not. Suspected tonsillitis in primary care or emergency departments During the COVID-19 pandemic, if a diagnosis of tonsillitis is suspected based on clinical history, the default becomes not examining the throat unless absolutely necessary. If using the to decide if antibiotics are indicated (validated in children 3 years and older), we suggest that a pragmatic approach is adopted (...) , and automatically starting with a score of 2 in lieu of an examination seems reasonable. Antibiotics should be considered in children with a total feverpain score of 4 or 5 (we suggest children with a score of 3 or less receive alone). Although this is likely to result in a temporary increase in antibiotic prescribing in children, we feel that this is preferable to healthcare staff being unnecessary exposed to COVID-19. Antibiotics rarely confer a benefit in children under 3 years with tonsillitis and should

2020 Royal College of Paediatrics and Child Health

140. COVID-19 - guidance for neonatal settings

. The family should be advised to self isolate with the baby for 14 days from birth. Term or late preterm baby requiring additional care Well babies born to suspected/confirmed COVID-19 mothers and who require additional care (eg intravenous antibiotics) should be assessed in the labour ward and a decision made as to whether additional care can safely be provided at the mother’s bedside. Avoid NNU admission if possible and safe. Babies requiring admission to the NNU should be assessed in a designated area

2020 Royal College of Paediatrics and Child Health


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