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Decontamination in Children

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21. Mouth-rinses for the prevention of chemotherapy induced oral mucositis in children: a systematic review. (PubMed)

Mouth-rinses for the prevention of chemotherapy induced oral mucositis in children: a systematic review. The purpose of this review was to evaluate studies in basic oral care interventions to update evidence based practice guidelines for preventing oral mucositis (OM) in cancer patients undergoing chemotherapy.Pub Med database and Google Scholar were searched for all papers published between 2000 and December 2014 in English that were conducted using the search terms including ''mocusitis (...) , chemotherapy, mouth-rinses, oral care, oral care protocol, dental care,dental cleaning, oral decontamination, oral hygiene", and the combined phrases in order to obtain all relevant studies.The initial search concluded 151 published papers representing both research and clinical work. Review articles, clinical case reports, literature reviews, and other nonresearch articles were excluded from the review. Following this process, 30 papers remained.Among these, chlorhexidine, normal saline, sodium

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2015 Iranian journal of pediatric hematology and oncology

22. Prevention of infectious complications after elective colorectal surgery in children: an American Pediatric Surgical Association Outcomes and Clinical Trials Committee comprehensive review. (PubMed)

Prevention of infectious complications after elective colorectal surgery in children: an American Pediatric Surgical Association Outcomes and Clinical Trials Committee comprehensive review. This goal of this review was to examine the clinical evidence in support of commonly utilized measures intended to reduce complications following elective colorectal surgery.Literature searches were performed to identify relevant studies from Medline, PubMed, and Cochrane databases.The American Pediatric (...) Surgery Association Outcomes and Clinical Trials Committee selected eight questions to address this topic systematically in the context of three management areas: 1) appropriate utilization of systemic antibiotics for colorectal procedures, 2) reduction of stool burden through mechanical bowel preparation, and 3) intraluminal gut decontamination through use of enteral nonabsorbable antibiotics. Primary outcomes of interest included the occurrence of infectious and mechanical complications related

2015 Journal of Pediatric Surgery

23. [The potential of prophylaxis and optimization of the treatment of rhinosinusitis in the children presenting with stenosing laryngotracheitis]. (PubMed)

therapy; moreover, it reduced the requirement for systemic antibiotics by 1.9 times. The treatment with fusaferine prevented the development of acute bilateral rhinosinusitis in the children with ASLT and promoted compete decontamination of the nasopharynx from M. catarrhalis, Str. pneumonia, Str. pyogenes, H. influenza, Cor. s the nasopharynx pecies, E. faecalis, and C. albicans. The frequency of adverse reactions of organoleptic character was estimated at 16.6%. (...) [The potential of prophylaxis and optimization of the treatment of rhinosinusitis in the children presenting with stenosing laryngotracheitis]. The objective of the present work was to estimate the clinical, prophylactic, and microbiological effectiveness of fusafungine applied for the treatment of acute rhinosinusitis (ARS) in the children that develops as a consequence of acute stenosing laryngotracheitis. The study included 61 children presenting with ARS and concomitant acute stenosing

2013 Vestnik otorinolaringologii

24. Case Series of Mercury Toxicity Among Children in a Hot, Closed Environment. (PubMed)

, respectively (P = 0.003). The 2 children who took the mercury home had the highest blood mercury levels and the most prolonged exposure time. N-acetylcysteine and chelation treatments were started in 21 children who had symptoms of mercury intoxication and high mercury levels in their blood or urine. No adverse effects were observed during chelation therapy. Prompt removal of children from contaminated environments and proper decontamination or elimination of devices containing large amounts of mercury (...) Case Series of Mercury Toxicity Among Children in a Hot, Closed Environment. Mercury poisoning is much more prevalent in the general population than possibly many physicians realize. We present data on 26 pediatric cases with mercury intoxication from exposure to mercury by inhalation or skin contact as a result of a broken thermometer in a school laboratory. This is the largest pediatric series in Turkey. During a 3-month period, the study team observed the children for clinical symptoms

2012 Pediatric Emergency Care

25. Test of environmental exposure to arsenic and hearing changes in exposed children (PubMed)

the source of the emissions was studied. On the basis of the results obtained, the most advantageous material for estimation of nonoccupational exposure to arsenic seems to be hair, in spite of some problems with the decontamination procedure involved. Considerable variability among individual arsenic values in the hair makes group examination a necessity. Hearing changes were analyzed in a group of 56 10-year old children residing near a power plant burning local coal of high arsenic content (...) Test of environmental exposure to arsenic and hearing changes in exposed children Arsenic determination was carried out on hair, urine, and blood samples taken from groups of 10-year-old boys, each numbering 20 to 25 individuals, residing in a region polluted by arsenic. In all the examined materials considerably elevated concentrations of arsenic were found. The relation of the observed levels of arsenic to the distance of the place of residence up to a distance of more than 30 km from

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1977 Environmental health perspectives

26. Evaluation of Vickers-Trexler isolator in children undergoing bone marrow transplantation. (PubMed)

Evaluation of Vickers-Trexler isolator in children undergoing bone marrow transplantation. Four children, 5 months to 15 years of age, underwent bone marrow transplantation in Vickers-Trexler isolator tents. Two grafts were elective. During 170 days of isolation no clinical infections due to exogenous micro-organisms developed despite severe immunodeficiency. The decontamination regimen and sterile procedures used, as well as the microbiological results, are described. This form of isolation

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1977 Archives of Disease in Childhood

27. Surgical site infections: prevention and treatment

information 27 Surgical site infections: prevention and treatment (NG125) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 3 of 27This guideline replaces CG74. This guideline is the basis of QS49. Ov Overview erview This guideline covers preventing and treating surgical site infections in adults, young people and children who are having a surgical procedure involving a cut through the skin. It focuses on methods used (...) surgery on a dirty or infected wound. [2008] [2008] 1.2.18 Inform patients before the operation, whenever possible, if they will need antibiotic prophylaxis, and afterwards if they have been given antibiotics during their operation. [2008] [2008] 1.3 Intraoperative phase Hand decontamination Hand decontamination 1.3.1 The operating team should wash their hands prior to the first operation on the list using an aqueous antiseptic surgical solution, with a single-use brush or pick for the nails

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

28. Infection Control for Haemodialysis Units

Immunisation Guidelines (1B). b) We suggest that HBsAg positive patients be dialysed in isolation or cohorted in an area that is separate to that where patients who are HBsAg negative receive dialysis (2C). c) We suggest that HBsAg positive patients use a dedicated dialysis machine and single-use dialysers. When dialysers are to be reused, they should be decontaminated and disinfected (2C). d) We suggest that in a routine setting, patients who are known to be positive for HIV or anti-HCV need (...) important in preventing contamination and interrupting the behaviours and practices that may propagate transmission, such as the reuse of syringes and the use of multi-dose drug vials. HCV can survive on surfaces at room temperature for up to 16 hours [27], underscoring the importance of adequate surface decontamination and disinfection. Screening Screening for HCV infection is usually performed using a third-generation enzyme immunoassays (EIA) test for HCV antibodies (anti-HCV), followed

2019 KHA-CARI Guidelines

29. Acute flaccid paralysis: clinical management guidance

not been systematically studied, with data limited to case reports or case series (1). In agammaglobulinaemic children, enteroviral infection has been associated with severe neurological disease, suggesting that antibody helps prevent severe disease (4). IVIG preparations have been shown to contain antibody against circulating enteroviruses (EV), including EV-D68 (5). In rodents, IVIG has been found to have some efficacy in preventing progression to neuroinvasive disease (1). In order to be effective (...) with non-polio enteroviruses since 2014 had full recovery (15). Clinical management of acute flaccid paralysis / acute flaccid myelitis (AFP/AFM): Information for health professionals 7 Rehabilitation Early physiotherapy and occupational therapy to maintain supple passive range of movement in the affected limbs during the period of paralysis is key to treatment. Evidence suggests that children with acute flaccid myelitis and other forms of myelitis can continue to regain strength and function

2019 Public Health England

30. Interventions for paracetamol (acetaminophen) overdose. (PubMed)

from the gastrointestinal tract (decontamination), removal of paracetamol from the vascular system, and antidotes to prevent the formation of, or to detoxify, metabolites.To assess the benefits and harms of interventions for paracetamol overdosage irrespective of the cause of the overdose.We searched The Cochrane Hepato-Biliary Group Controlled Trials Register (January 2017), CENTRAL (2016, Issue 11), MEDLINE (1946 to January 2017), Embase (1974 to January 2017), and Science Citation Index Expanded (...) studied included decontamination, extracorporeal measures, and antidotes to detoxify paracetamol's toxic metabolite; which included methionine, cysteamine, dimercaprol, or acetylcysteine. There were no randomised clinical trials of agents that inhibit cytochrome P-450 to decrease the activation of the toxic metabolite N-acetyl-p-benzoquinone imine.Of the 11 trials, only two had two common outcomes, and hence, we could only meta-analyse two comparisons. Each of the remaining comparisons included

2018 Cochrane

31. Organophosphate poisoning

is usually based on a history of exposure, with characteristic signs of cholinergic excess, but can be difficult when the patient is inadvertently exposed or is unconscious or confused. Standard treatment is resuscitation, supportive care, decontamination, and use of atropine. Accidental or occupational exposures nearly always have a favourable outcome. Definition Poisoning occurs after dermal, respiratory, or oral exposure to either organophosphate pesticides (e.g., chlorpyrifos, dimethoate, malathion (...) of Clinical Pharmacology Pharmacology Department Sydney Medical School University of Sydney Sydney New South Wales Australia Disclosures NB declares that he has no competing interests. Peer reviewers Assistant Professor of Emergency Medicine Division of Medical Toxicology University of Massachusetts Medical School North Worcester MA Disclosures SBB declares that he has no competing interests. Program Director Medical Toxicology Regional Poison Center Children's Hospital of Michigan Detroit MI Disclosures

2018 BMJ Best Practice

32. Handbook on tuberculosis laboratory diagnostic methods in the European Union

45 4.9.1 Quality control parameters 45 References 45 5. Culture tests for Mycobacterium tuberculosis complex 47 5.1 Background and principles 47 5.2 Biohazards and biosafety in the TB laboratory 47 5.2.1 Minimum WHO recommendations for TB culture/drug susceptibility testing facilities 48 5.3 Specimen collection, storage and transport 49 5.3.1 Sample collection 49 5.3.2 Storage of specimens 50 5.3.3 Transportation of specimens 50 5.4 Homogenisation and decontamination of specimens 50 5.4.1 (...) Digestion and decontamination of sputum samples 51 5.4.2 Digestion and decontamination of specimens other than sputum 53 5.5 Culture media: principles 54 5.6 Solid media 54 5.6.1 Egg-based media 54 5.6.2 Agar-based media 54 5.6.3 Liquid media 55 5.6.4 Quality control of media 55 5.7 Culture tube inoculation 55 5.7.1 Solid media 55 5.7.2 Liquid media 56 5.8 Culture incubation 56 5.9 Culture examination 56 References 58 6. Identification of Mycobacterium tuberculosis and drug resistance in cultures

2018 European Centre for Disease Prevention and Control - Technical Guidance

33. Surveillance of healthcare-associated infections and prevention indicators in European intensive care units: HAI-Net ICU protocol, version 2.2

hours after prescription ? prevention of pneumonia in intubated patients: control of cuff pressure, oral decontamination, patient position ? CVC maintenance care: catheter site dressing is not damp, loose or visibly soiled. Patient data (standard surveillance option only): addition of a variable allowing to select a second severity score (from a list, in addition to SAPS II) and enter its value, deletion of: APACHE II, date of hospital admission, coronary care, site of previous surgery, parenteral (...) controlled and/or corrected at least twice a day ? oral decontamination using oral antiseptics at least twice a day. The percentage of correct cuff pressure and oral decontamination records is collected by 30 consecutive reviews of the files of intubated patients (each patient is observed once per day, the same patient is observed for several consecutive days) during the evaluation period ? position of the patient not supine (direct observation). ? Prevention of central line associated bloodstream

2017 European Centre for Disease Prevention and Control - Technical Guidance

34. CRACKCast E163 – Pesticides

not be used in infants younger than 2 months old. DEET in concentrations of more than 30% should not be used in children and may result in neurotoxicity and self-limited seizure activity if used in excessive amounts. Most rodenticide exposures will be superwarfarin compounds. For large exposures, INR should be checked at a minimum of 2 days after ingestion. Vitamin K should be used for reversal; blood products should be used for active bleeding. Rosen’s In Perspective Pesticide is a general term (...) waiting for laboratory confirmation of decreased cholinesterase activity. Other laboratory studies should focus on the evaluation of pulmonary, cardiovascular, and renal function and fluid and electrolyte balance. A measurement of acid-base status should be performed, because patients with acidosis have higher mortality than those without. Treatment of organophosphate poisoning is directed toward four goals: (1) Decontamination Start this out of hospital!! Protect more people from getting affected

2018 CandiEM

35. Tide Pod Challenge: Managing caustic laundry pod ingestions

can be severe in some cases, given that the chemicals in pods are in very high concentration. As a result, it is crucial that those on the front line are familiar with how to handle these emergencies. 1 EPIDEMIOLOGY Laundry pod ingestion can present in a variety of populations. These exposures are generally divided into: (1) intentional (in persons with suicidal ideation and more recently the “Tide Pod Challenge”), (2) accidental (in children or adults with dementia), and (3) incidental (due (...) , and/or vomiting, drooling, or food refusal with or without oropharyngeal burns). Prompt endoscopy is required, and should be done in <12 hours, and not >24 hours due to risk of iatrogenic perforation. MANAGEMENT Decontamination takes priority. Staff should wear appropriate PPE as required, and should remove soiled clothing from patient to prevent dermal burns. Staff may be exposed to the caustic agent through vomit, and careful care should be taken around this. The first line of management is to stabilize

2018 CandiEM

36. CRACKCast Episode 149 – Aspirin and Nonsteroidal Agents

mechanism Tinnitus: Cochlear toxicity is thought to be the result of alterations in N-methyl-D-aspartate (NMDA) activity, decreased blood flow, and increased membrane permeability [2] What is the toxic dose of ASA? Mild – moderate toxicity = 150-300 mg/kg Severe toxicity = > 300 mg/kg Ingestions of >500 mg/kg are associated with death. Fatal salicylate intoxication can occur after the ingestion of 10 to 30 g by adults and as little as 3 g by children . Death typically results from severe central nervous (...) responds to supportive measures. Ibuprofen is the most common NSAID ingested in overdose and most cases follow a benign, self-limited course. Symptomatic overdose occurs only after ingestion of at least 100 mg/kg, and symptoms develop within 4 hours of ingestion. Life-threatening toxicity is rare with most cases limited to mild GI disturbance that resolves in hours. Treatment: Decontamination: There is no evidence supporting the use of gastric emptying or AC in NSAID overdoses. Enhanced Elimination

2018 CandiEM

37. CRACKCast E147 – General Approach to the Poisoned Patient

this toxicology stuff is: Make diagnosis / or suspect the ingestion/exposure/overdose/toxicity Ask those five W’s and H’s Who took it? What did they take, and any other co-ingestions? When did they take it? Where did they take it (packer, stuffer, IV, PO, Intranasal, transdermal, rectal)? Why did they take it (i.e. suicide vs occupational vs accidental) ? How MUCH did they take? Initiate decontamination Prevent absorption Enhance drug elimination Give any antidotes When it comes to history, get as much (...) : Activated charcoal is a carbonaceous substance that has been exposed to high heat and steam, resulting in a large surface area to volume ratio, to provide ample surface space for ingested substances to adsorb, and thus decrease absorption into the body Activated charcoal historically has most often been given in a dose of 25 to 100 grams (10 to 25 grams or 0.5 to 1.0 gram/kilogram in young children) Customize the dose to the dose of the ingested agent by administering activated charcoal in a weight

2018 CandiEM

38. CRACKCast E193 – Disaster Preparedness

. Planners should establish and exercise a hospital-based incident management system. Disaster planning needs to include policies to address the needs of vulnerable populations, such as children, disabled, and the elderly. Rosen’s in Perspective: Disasters occur all over the world, regardless of governments, wars, poverty, or wealth Double-hit: not only do you have large numbers of people injured, but you also can have damage to the infrastructure used to care for those patients. Increasing population (...) ’) Personnel: roster of all critical positions and the personnel who will fill them, including backup persons for each position. A policy for managing volunteers (especially uncontrolled or unscheduled volunteers who often appear at hospitals in the case of a disaster and can be disruptive) Patient Management: protocols for decontamination, triage, prioritization, and evacuation of patients Training Exercises: all essential departments should participate in regular scheduled drills, including community

2018 CandiEM

39. CRACKCast E191 – Weapons of Mass Destruction

if the unthinkable should happen. Shownotes – Key concepts Emergency department (ED) preparedness for a radiation incident should address decontamination (an external freestanding decontamination unit is best), triage, staff safety, personal protective equipment (PPE), and diagnostic procedures that emphasize radiation monitoring. It is important that emergency personnel know their radiation safety officer. Management of acute life-threatening conditions takes priority over radiation-associated issues. Aerosol (...) dispersal is a likely route that terrorists may use to deploy biologic weapons, so victims will present primarily with respiratory complaints. In addition to “flulike” symptoms, anthrax typically causes mediastinal widening, pulmonary consolidation, and pleural effusions best seen on chest computed tomography (CT) scans. Smallpox can spread in a hospital environment; thus, patients thought to have smallpox should be admitted to locations separated from the rest of the hospital. Decontamination is a key

2018 CandiEM

40. CRACKCast E157 – Iron and Heavy Metals

decontamination method of choice for iron and lead toxicity with radiographic presence of pills or paint chips is WBI. The chelation agent of choice for acute arsenic poisoning is intramuscular British anti-lewisite (BAL) or oral succimer. Elemental mercury is nontoxic to the gastrointestinal tract but may cause pulmonary and CNS toxicity from inhalation of volatilized Vapors. Rosen’s in Perspective Iron OD in children used to be a big killer, but nowadays with new FDA regulations there are few deaths. Iron (...) preparations with non-ionic iron have MUCH lower toxicity = i.e. no reported cases of serious toxicity! 2. What amount of ingested iron / iron level constitutes Mild toxicity/Moderate toxicity/Severe toxicity? Ingesting 60mg/kg LD50 (50% mortality) = 200-250 mg/kg That being said doses as little as 130 mg in children have been lethal. Peak serum iron below 350 μg/dL is generally associated with minimal toxicity; 350 to 500 μg/dL (90

2018 CandiEM

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