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161. 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

162. 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

163. 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

164. 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

165. Coronavirus (COVID-19) infection and pregnancy

to blood cultures. • While pyrexia may suggest COVID-19, do not assume that all pyrexia is due to COVID-19. Consider the possibility of bacterial 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 tested for COVID-19 if they meet the inpatient or community PHE criteria. o Current

2020 Royal College of Obstetricians and Gynaecologists

166. Management of Tick Bites and Lyme Disease During Pregnancy

with a tick bite or suspected Lyme disease should be managed similarly to non-pregnant adults, including the consideration of antibiotics for prophylaxis and treatment. The primary objective of this committee opinion is to inform practitioners about Lyme disease and provide an approach to managing the care of pregnant women who may have been infected via a blacklegged tick bite. Intended users Health care providers who care for pregnant women or women of reproductive age. Target population Women (...) series. BMC Infect Dis. 2009; 9 : 79 Warshafsky S Lee DH Francois LK et al. Efficacy of antibiotic prophylaxis for the prevention of Lyme disease: an updated systematic review and meta-analysis. J Antimicrob Chemother. 2010; 65 : 1137-1144 Cross R Ling C Day NP et al. Revisiting doxycycline in pregnancy and early childhood–time to rebuild its reputation?. Expert Opin Drug Saf. 2016; 15 : 367-382 National Institute for Health and Care Excellence (NICE) Lyme disease (NG95). NICE , London, United

2020 Society of Obstetricians and Gynaecologists of Canada

167. Low-Risk Infant Ground Transport in the Care of a Registered Nurse: Practice Resource

transfer in the care of an RN, the following clinical parameters must be met: CLINICAL PARAMETER YES NO* N / A Gestational age = 32 weeks PMA Current weight = 1500 grams On supplemental oxygen by Low Flow Nasal Prongs (LFNP) not requiring additional pressure support for > 48 hours prior to transport If on caffeine, no major episodes of apnea requiring positive pressure ventilation for > 48 hours prior to transport Saline lock can be placed for transport if on intravenous (IV) fluid and / or antibiotics (...) ? Dextrose concentration greater than D12.5%W for hypoglycemia ? Medications for hypoglycemia ? Post op with enteral feeds less than full feeds ? Gastrostomy less than 10 days post-op ? Jejeunal tube ? Ileostomy ? Jejunostomy ? Post op with enteral feeds less than 50% ? Mucous fistula refeeds Other ? Phototherapy ? Post cesarean section ? Terminal palliative care, with no invasive interventions required ? Boarder baby ? Antibiotics in a well baby with risk factors ? ROP: less than weekly checks

2020 British Columbia Perinatal Health Program

168. 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

169. 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

170. 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

171. 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

173. 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

174. Guide for Completion of the Neonatal Transfer Record

at the beginning of the list. ? Car Bed added as an option in Environment for transfer. ? Care transferred to HART removed. Section 1: ? Maternal / Birth History: Free text box replaced with pertinent questions such as antenatal steroids, prophylactic antibiotics, and delivery type. Section 2: ? Newborn Exposure: Checkbox added to indicate if exposure is unknown. Summary of Changes WHAT’S NEW? The updated record was developed to reflect the recommendations of the BC Coroners report, the Provincial Patient (...) handover.BC Neonatal Transfer Record (PSBC 1995) 6 ABG Arterial Blood Gas ARO Antibiotic Resistant Organisms B Bottle BD Base Deficit BE Base Excess BP Blood Pressure BR Breast CBG Capillary Blood Gas CCHD Critical Congenital Heart Disease CPAP Continuous Positive Airway Pressure CVAD (CVC) Central Venous Access Device (Central Venous Catheter) EBM Expressed Breast Milk ETT Endotracheal Tube F female FiO 2 Fractional concentration of inspired oxygen GBS Group B Streptococcal GI/GU Gastrointestinal

2020 British Columbia Perinatal Health Program

177. Appropriate Use Criteria: Imaging of the Chest

cough syndrome, and gastroesophageal reflux. 25 CHRONIC COUGH IN PEDIATRIC PATIENTS The majority of pediatric patients with chronic wet cough will respond to antibiotic treatment with a number needed to treat of 3. 27,28 Fever of unknown origin Advanced imaging is considered medically necessary in EITHER of the following scenarios: ? Fever of duration greater than 3 weeks, which is unexplained following a standard diagnostic evaluation to identify the source ? Unexplained fever in immunocompromised

2021 AIM Specialty Health

178. Covid-19: Management of palliative care in hospital during the coronavirus pandemic

not already exist. NHS England and NHS Improvement Goals of care The treatment of patients suffering from coronavirus may be orientated towards: • • • Supportive measures – for example, provision of fluids and/or oxygen. Targeted treatment – for example, provision of antibiotics to treat pneumonia. Organ support – for example, ventilator support, renal replacement therapy, etc. These are aimed at preserving and prolonging life. It is important to remember that most people with coronavirus will survive (...) supportive treatments and management of their comorbidities has been optimised. The good practice approach to symptom management is as follows: • Correct the correctable, for example, give the patient antibiotics for a bacterial infection. • Non-drug approaches, especially in mild to moderate disease – see Appendix 1. 3 | Clinical guide for the management of palliative care in secondary care during the coronavirus pandemic, Version 1 • Drug approaches – see Appendix 1. The most common symptoms

2020 Covid-19 Ad hoc guidelines

179. ACG Clinical Guideline: Management of Irritable Bowel Syndrome

exposed to any of these pathogens as compared to nonexposed individuals. It is worth noting that this prevalence rate seems higher than recently published data ( ) because of differences in how patients were defined and categorized. Postinfection IBS is more commonly seen in women, those exposed to antibiotics, and when there is a history of anxiety or depression ( ). Although bacterial and viral gastroenteritides are acute and associated with alarm symptoms, parasitic infections range from (...) % and specificities of 91.5%–100% ( ). Since Giardiasis has the highest prevalence in developing countries, it is reasonable to perform testing in these areas. In addition, in the appropriate clinical setting (e.g., travel to endemic areas, poor water quality, camping, and daycare exposure), testing is warranted. As testing for bacterial and viral infections with subsequent treatment does not prevent development of IBS, and in fact antibiotic exposure may be a risk factor for postinfection IBS, we do

2021 American College of Gastroenterology

180. Consensus Guidelines for Evaluation and Management of Pulmonary Disease in Sjögren’s

. In Sjögren’s patients with small airway disease, time-limited empiric therapy in newly diagnosed and previously untreated disease may include: ? A short course of systemic steroids for 2-4 weeks with a repeat spirometry to determine reversibility, especially if uncontrolled asthma is suspected ? Nebulized or inhaled short or long-acting bronchodilators and/or inhaled corti- costeroids if there is physiological obstruction ? Shortcourse(ie,2-3months)ofempiricmacrolide antibiotics (mostcommonly

2021 American College of Chest Physicians


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