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Decontamination in Children

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61. The Use of Laser Irradiation in Adjunct with Calcium Hydroxide Treatment of Direct Pulp Capping Procedures Leads to Higher Success Rates than Calcium Hydroxide Alone

in the success of direct pulp capping procedures employing laser irradiation to provide hemostasis and decontamination of the pulp exposure before placement of calcium hydroxide. The success rates were determined by the percentage of vital teeth at the final follow-up appointments. This treatment is within the capability of the average general dentistry practice and is likely to be supported by the patient to increase the likelihood of keeping the tooth vital at minimal financial cost. Best Evidence (you may (...) view more info by clicking on the PubMed ID link) PubMed ID Author / Year Patient Group Study type (level of evidence) #1) Javed/2017 687 children and adults in 6 included studies with pulp exposures Meta-Analysis Key results The success rate for maintaining pulpal vitality was significantly higher in the treatment group compared to the control group (log odds ratio = 1.737; 95% confidence interval, 1.304 - 2.171). The meta-analysis found that 80% of the included studies showed that the use

2017 UTHSCSA Dental School CAT Library

62. Introduction to the Centers for Disease Control and Prevention and the Healthcare Infection Control Practices Advisory Committee Guideline for the Prevention of Surgical Site Infections

Site Infections Patient-related factors Age [ ] Obesity or malnutrition [ , , ] Diabetes or hyperglycemia [ ] Smoking [ ] Colonization [ , ] Remote infection [ ] Pre-operative hospital stay [ ] Procedure-related factors Instrument cleaning, decontamination, and sterilization Operating room ventilation [ ] Pre-operative shaving [ ] Surgical skin preparation [ , ] Surgical scrub [ ] Surgical technique [ ] Surgical drains [ ] Tourniquet time [ ] Revision arthroplasty [ ] Procedure duration [ , ] Table (...) tissue and pulmonary infections from community-associated MRSA has increased dramatically, particularly in children and young, immunocompetent adults [ ]. Although initially described as community-associated or community-onset MRSA, this strain is now quite common in healthcare settings and is replacing other strains of MRSA as a cause of HAIs [ ]. The USA300 strain also has become a common pathogen for SSIs; it is the most common form of S. aureus found in SSIs in hospitalized patients

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2017 Surgical Infection Society

63. Video laryngoscopes to help intubation in people with difficult airways

people in hospital. User surveys show that availability, routine use and positive attitudes towards video laryngoscopy have increased over time. K Ke ey uncertainties y uncertainties around the evidence are a lack of evidence for use in children and babies and any published economic evidence. © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 1 of 26The cost cost of video laryngoscopes range from £245 to £7,149 per unit (...) routine induction of anaesthesia in children aged 1 to 8 years, states that more research is needed in the use of video laryngoscopes. Age is a protected characteristic under the Equality Act 2010. Clinical and technical e Clinical and technical evidence vidence A literature search was carried out for this briefing in accordance with the interim process and methods statement. This briefing includes the most relevant or best available published evidence relating to the clinical effectiveness

2019 National Institute for Health and Clinical Excellence - Advice

65. Specimen collection – microbiology and virology

Specimen collection – microbiology and virology Specimen collection – microbiology and virology | Great Ormond Street Hospital Google Tag Manager Navigation Search Search You are here Specimen collection – microbiology and virology Specimen collection – microbiology and virology Microbiological and virological laboratory testing has a key role in the management of children with infection. Accurate and rapid identification of significant microorganisms is vital for guiding optimal antimicrobial (...) wound infection Any antimicrobial drug(s) given Consultant's name Name/bleep number of the clinician who ordered the investigation, as it may be necessary to telephone preliminary results and discuss treatment before the final result is authorised In children with suspected infections of hazard group 3 and 4 pathogens (eg Middle East Respiratory Syndrome (MERS), Severe Acute Respiratory Syndrome (SARS), viral haemorrhagic fevers such as Lassa fever, Marburg or Ebola virus) the Infection Prevention

2017 Publication 1593

66. Ultrasound Guidelines: Emergency, Point-of-care, and Clinical Ultrasound Guidelines in Medicine

other emergency US applications. Other Settings or Populations Pediatrics. US is a particularly advantageous diagnostic tool in the management of pediatric patients, in whom radiation exposure is a significant concern. EUS applications such as musculoskeletal evaluation for certain fractures (rib, forearm, skull), and lung for pneumonia may be more advantageous in children than in adults due to patient size and density. 7 US can be associated with increased procedural success and patient safety

2016 American College of Emergency Physicians

67. Quality Standards for Paediatric Gastroenterology, Hepatology & Nutrition

of improvement are required in gastroenterology, hepatology and nutrition to ensure children are receiving timely, high quality services as close to home as possible. It is clear that there is heterogeneity in the way that services are being provided to children across the UK. These standards have been developed alongside the principles laid out by the RCPCH ‘Bringing Networks to Life’ publication that underpins the direction of travel for all paediatric services to be planned and provided through funded (...) managed clinical networks. These standards have been developed using the experience and authority of the RCPCH with the specialist expertise and knowledge of BSPGHAN throughout 2016. Extensive consultation with children and their families together with input from key stakeholders has helped to influence and steer the process of producing a key set of definitive standards. We are committed towards supporting the membership of RCPCH and BSPGHAN by asking commissioners and service planners across the UK

2017 British Society of Paediatric Gastroenterology Hepatology and Nutrition

68. Medication impregnated dressings for central venous catheters reduce the number of bloodstream infections, but the quality of the research is low

dressings halved the frequency of bloodstream infections per 1000 patient days compared with standard polyurethane dressings (RR 0.51, 95% CI 0.33 to 0.78). This was from a meta-analysis of four studies. There was no difference in skin irritation or damage between chlorhexidine gluconate-impregnated dressings and polyurethane dressings. However, this outcome was only examined in two studies in children and new born infants. There was not enough evidence to assess other devices or dressings (...) , such as those impregnated with silver or iodine. What does current guidance say on this issue? NICE guidance from 2012 recommends that the central venous catheter insertion site and surrounding skin should be decontaminated during dressing changes using chlorhexidine gluconate in 70% alcohol, and that a sterile transparent semipermeable (polyurethane) membrane dressing should cover the vascular access device insertion site. NHS England’s “epic3” guidance similarly recommends cleaning the skin

2018 NIHR Dissemination Centre

69. U.S. Cystic Fibrosis Foundation and European Cystic Fibrosis Society consensus recommendations for the management of nontuberculous mycobacteria in individuals with cystic fibrosis

, Sarah E Hempstead , Karsten Koetz , Kathryn A Sabadosa , Isabelle Sermet-Gaudelus , Alan R Smyth , Jakko van Ingen , Richard J Wallace , Kevin L Winthrop , Bruce C Marshall , Charles S Haworth Statistics from Altmetric.com Background Epidemiology of non-tuberculous mycobacteria in individuals with cystic fibrosis Non-tuberculous mycobacteria (NTM) are increasingly being isolated from the sputum of adults and children with cystic fibrosis (CF), both in North America and in Europe. Estimates (...) , with prevalence increasing from 10% in children aged 10 years, to over 30% in adults over the age of 40 years. In individuals with an adult diagnosis of CF, over 50% (mostly females) have NTM-positive airway cultures. There appear to be species-specific differences in age-related prevalence within CF cohorts, with MAC more commonly isolated from adults over 25 years of age, , , , , while MABSC is isolated from all age groups, but peaks between those 11 and 15 years of age in some studies. , There may also

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2016 Cystic Fibrosis Foundation

72. Medication impregnated dressings for central venous catheters reduce the number of bloodstream infections, but the quality of the research is low

dressings halved the frequency of bloodstream infections per 1000 patient days compared with standard polyurethane dressings (RR 0.51, 95% CI 0.33 to 0.78). This was from a meta-analysis of four studies. There was no difference in skin irritation or damage between chlorhexidine gluconate-impregnated dressings and polyurethane dressings. However, this outcome was only examined in two studies in children and new born infants. There was not enough evidence to assess other devices or dressings (...) , such as those impregnated with silver or iodine. What does current guidance say on this issue? NICE guidance from 2012 recommends that the central venous catheter insertion site and surrounding skin should be decontaminated during dressing changes using chlorhexidine gluconate in 70% alcohol, and that a sterile transparent semipermeable (polyurethane) membrane dressing should cover the vascular access device insertion site. NHS England’s “epic3” guidance similarly recommends cleaning the skin

2018 NIHR Dissemination Centre

73. Guidelines for the Management of Severe Traumatic Brain Injury (4th edition)

¶University of Pittsburgh, Pittsburgh, Pennsylvania Search for other works by this author on: Robert C. Tasker, MBBS, MD ¶¶Harvard Medical School & Boston Children's Hospital, Boston, Massachusetts Search for other works by this author on: Monica S. Vavilala, MD ‖University of Washington, Seattle, Washington Search for other works by this author on: Jack Wilberger, MD ‖‖Drexel University, Pittsburgh, Pennsylvania Search for other works by this author on: David W. Wright, MD ##Emory University, Atlanta

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2016 Congress of Neurological Surgeons

74. Management of scabies

is spared except in children. Palms and soles are also affected in the elderly and in infants and young children. The pathognomonic lesion is the burrow, which is a linear intra-epidermal tunnel produced by the moving mite and appears as short wavy greyish/ white threadlike elevations of 2-10 mm in length. Burrows are difficult to find if there is excoriation or secondary eczematisation. Nodular lesions may also be seen especially on the penis and scrotum in men, buttocks, groin, and the axillary (...) four days before treatment should be decontaminated by washing at high temperature (60°C) and drying in a hot dryer, by dry-cleaning, or by sealing in a plastic bag for at least 72 hours 5,9 . Scabies mites generally do not survive more than 72 hours days away from human skin. Patients must be given information about scabies, including proper application of topical scabicides. Recommended regimens Permethrin 5% cream. 37 (Level of evidence 1b A) ? apply to the whole body from the chin and ears

2016 British Association for Sexual Health and HIV

76. Meticillin-resistant Staphylococcus aureus (MRSA): control and management

. These, and other evidence, show: The key points are: Implementation of screening policy (including staff at start of employment) to identify MRSA carriage and cross-infection, including procedures to notify children/young people, their carers and staff of the MRSA results. Identification, and ‘alerting’, of MRSA-positive patients (who have been detected through screening patients on admission or at pre-admission clinics, or from routine diagnostic testing) followed by implementation of additional control steps (...) control Instruments and equipment (e.g. stethoscopes, sphygmomanometers with cuffs, monitors, pens, scissors etc.) should be designated to the patient with MRSA and, on discharge or transfer, cleaned with sanitising wipes (e.g. Clinell ® ) or according to manufacturer’s instructions. Items such as IV trays, food trays, patient bedside testing equipment (e.g. glucometer, blood tracking device) and tablet computers (e.g. IPads) should be decontaminated with sanitising wipes (e.g. Clinell ® ) prior

2016 Publication 1593

77. Healthcare-associated infections

should be: Educated about the standard principles of infection prevention and control. Trained in hand decontamination, the use of personal protective equipment and the safe use and disposal of sharps. Additional precautions should be used when inserting and managing invasive devices, including: Ensuring all equipment is sterile, packaging is intact and within the expiry date. Performing skin decontamination prior to inserting a device through the skin (for example using 2% Chlorhexidine in 70 (...) healthcare from healthcare workers who decontaminate their hands immediately before and after every episode of direct contact or care. People who need a urinary catheter have their risk of infection minimised by the completion of specified procedures necessary for the safe insertion and maintenance of the catheter and its removal as soon as it is no longer needed. People who need a vascular access device have their risk of infection minimised by the completion of specified procedures necessary

2019 NICE Clinical Knowledge Summaries

78. Biopatch for venous or arterial catheter sites

randomised controlled trials in a total of 3,674 adults and children in secondary care settings. Results are mixed with some evidence showing reductions in rates of bacterial colonisation and the number of CRBSIs compared with standard dressings in patients with venous or arterial catheters, and some showing no difference between Biopatch and standard care. K Ke ey uncertainties y uncertainties around the evidence and technology are whether it is as effective at reducing the number of CRBSIs (...) the catheter. After catheter insertion, a sterile transparent semipermeable membrane dressing should be used to cover the insertion site. This should be changed every 7 days, or sooner if moisture collects under the dressing or there are signs of infection. The same skin decontamination process should be used whenever the dressing is changed. NICE also advices maintenance of the catheter itself by cleaning it with 2% CHG in 70% alcohol before accessing the system and also flushing and locking the catheter

2017 National Institute for Health and Clinical Excellence - Advice

79. Healthcare-associated infections: prevention and control in primary and community care

feeding 22 1.4 Vascular access devices 24 2 Research recommendations 29 2.1 Standard principles of infection prevention and control 29 2.2 Hand decontamination 29 2.3 Intermittent urinary catheters: catheter selection 30 2.4 Indwelling urinary catheters: catheter selection 31 2.5 Indwelling urinary catheters: antibiotic prophylaxis 31 2.6 Vascular access devices: skin decontamination 32 More information 32 Update information 33 Healthcare-associated infections: prevention and control in primary (...) and community care (CG139) © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 3 of 33This guideline replaces CG2. This guideline is the basis of QS61. Ov Overview erview This guideline covers preventing and controlling healthcare-associated infections in children, young people and adults in primary and community care settings. It provides a blueprint for the infection prevention and control precautions that should be applied

2012 National Institute for Health and Clinical Excellence - Clinical Guidelines

80. Acute pain management: scientific evidence (3rd Edition)

PATIENT 339 10.1 Developmental neurobiology of pain 339 10.2 Long-term consequences of early pain and injury 340 10.3 Paediatric pain assessment 340 10.3.1 Pain assessment in neonates 341 10.3.2 Observational and behavioural measures in infants and children 342 10.3.3 Self-report in children and adolescents 342 10.3.4 Children with cognitive impairment 343 10.4 Management of procedural pain 346 10.4.1 Procedural pain in the neonate 347 10.4.2 Procedural pain in infants and older children 347 10.4.3 (...) Immunisation pain in infants and children 349 10.4.4 Procedural pain management in the emergency department 349 10.5 Analgesic agents 351 10.5.1 Paracetamol 351 10.5.2 Non-selectiv e non-steroidal anti-inflammatory drugs 352 10.5.3 Coxibs 353 10.5.4 Opioids and tramadol 354 10.5.5 Cortic osteroids 356 10.5.6 Other pharmacological therapies 356 10.6 Opioid infusions and PCA 357 10.6.1 Opioid infusions 357 10.6.2 Patient-controlled analgesia 358 10.6.3 Nurse-controlled analgesia 358 10.7 Regional analgesia

2015 National Health and Medical Research Council

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