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Decontamination in Children

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81. Bites - human and animal

paracetamol dosing for children has been introduced by the Medicines and Healthcare products Regulatory Agency. Prescriptions have been updated to reflect the revised dosing. Issued in July 2011. May 2011 — minor update. The 2010/2011 QIPP options for local implementation have been added to this topic. Issued in June 2011. March 2011 — topic structure revised to ensure consistency across CKS topics — no changes to clinical recommendations have been made. August 2009 — minor update. Advice from (...) bites require antibiotic prophylaxis. Issued May 2008. November 2007 — minor update to the text for animal bites. CKS now recommends that specialist advice should be sought for children under 12 years old who require antibiotic treatment and are allergic to penicillin, because they are unable to receive a tetracycline. Issued in December 2007. August 2007 — minor update to text to clarify that, if tetanus vaccination is required, a combined tetanus vaccination should be used. Minor rewording

2018 NICE Clinical Knowledge Summaries

82. Gastric lavage in the diagnosis of pulmonary tuberculosis in children: a systematic review. (PubMed)

years;" "gastric lavage and tuberculosis and childhood" or "gastric washing and tuberculosis and childhood." There were retrieved 80 articles and their analysis was based on information on the gastric lavage protocol for the diagnosis of pulmonary tuberculosis in children: preparation of children and fasting; time of gastric aspiration; aspiration of gastric residues; total volume of aspirate; solution used for aspiration of gastric contents; decontaminant solution; buffer solution; and time (...) Gastric lavage in the diagnosis of pulmonary tuberculosis in children: a systematic review. To analyze standardization of gastric lavage protocols in the diagnosis of pulmonary tuberculosis in children.A systematic review was conducted for the period between 1968 and 2008 in the following databases: LILACS, SCIELO and MEDLINE. The search strategy included the following terms: "gastric lavage and tuberculosis" or "gastric washing and tuberculosis" with the restriction of "children aged up to 15

2010 Revista de saúde pública

83. A Pilot Study of Filtrum-STI in Children With Viral Gastroenteritis

A Pilot Study of Filtrum-STI in Children With Viral Gastroenteritis A Pilot Study of Filtrum-STI in Children With Viral Gastroenteritis - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. A Pilot Study (...) of Filtrum-STI in Children With Viral Gastroenteritis (F-GE-09) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT01113346 Recruitment Status : Unknown Verified July 2010 by Avva Rus, JSC. Recruitment status was: Recruiting First Posted : April 29, 2010 Last Update Posted : July 14, 2010 Sponsor: Avva Rus

2010 Clinical Trials

84. David Nott: Crossing red lines in Syria

, a field hospital was shelled 20 times in two days. In Aleppo, military aircraft completely destroyed the Children’s Hospital and attempted to destroy all the other well known hospitals in the city. This necessitated the construction of secret field hospitals given secret names to try to continue treating the wounded. In 1953, Syria signed the Geneva conventions and fully understood the implications of breaches of humanitarian law. It then follows that by the end of 2012, the first red line was crossed (...) ”. He warned that Assad would be held accountable by the international community if he deployed chemical munitions. On 21 August 2013, the Syrian government used rocket launchers to propel sarin gas into a suburb of Eastern Ghouta killing nearly 1,500 civilians including at least 426 children according to US assessments. The international community was in uproar and this prompted the British government to obtain legal advice by the British attorney general who confirmed that military action would

2018 The BMJ Blog

85. Tropical Travel Trouble 011 Tonsillitis and the Bull

included in the childhood vaccination schedule since the 1920s in most developed countries. Therefore, those most at risk are the unimmunised. Sporadic outbreaks are seen in mostly in disadvantaged groups who live in crowded conditions. Adults and children under 5 are most at risk of dying from diphtheria with a mortality rate of up to 20%. ** Q7. How does diphtheria present clinically? Answer and interpretation C. diphtheriae can infect any mucosal cell. There are two main forms of the disease (plus (...) only after discussion with a specialist. Complications as seen with snake antivenom : anaphylaxis and serum sickness. ** Details on Diphtheria and Diphtheria . Q9. How do you prevent diphtheria? Answer and interpretation Mass vaccination is the best form of prevention. WHO recommends a 3-dose primary vaccination series with diphtheria toxoid, followed by a booster dose. Children in Australia and New Zealand receive up to 6 doses of DTPa vaccine (diphtheria, tetanus and acellular pertussis toxoid

2018 Life in the Fast Lane Blog

86. Button Battery Update

ingestion more frightening is the fact that the ingestion may go unwitnessed, the child may have vague symptoms like ‘off food’ and later haematemasis can result from erosion of the battery through the oesophagus and into the thoracic aorta. Peer reviewer Dr Ruth Barker, Director, Queensland Injury Surveillance Unit and Emergency Paediatrician, Lady Cilento Children’s Hospital, Brisbane. Mechanism of injury: The button battery generates hydroxide ions at the negative pole once ingested (...) to lodge in the oesophagus and cause complications (although relatively bigger batteries in small children increases risk despite being <20 mm). Batteries >20 mm can cause severe local damage within 2 hours. Smaller batteries can also cause localised damage when placed in aural or nasal cavities. Age and time of presentation Age is a risk factor as most fatalities occur in the under 4 year old age group. But consider non-mobile infants can be fed by siblings, patients who are autistic can have

2018 Life in the Fast Lane Blog

87. Scabies

the insecticide should be applied. Considering symptomatic treatment for itching (e.g. topical crotamiton). Treating any associated conditions (e.g. infection). Scabies is rare in children under 2 months of age. Specialist advice should be sought (e.g. from a paediatric dermatologist) if treatment is required for this age group. Follow-up is not generally required. However, the person should be reviewed if symptoms have not cleared within 2–4 weeks after the first application of treatment. Specialist advice (...) in children. Palms and soles may be affected in elderly people, infants, and young children. Nodules — particularly common on penis and scrotum in men, the buttocks, groin, and axillary regions. These are violet in colour and intensely pruritic. Ask about/note: Whether family members/close contacts have also reported itching. The person's living conditions — scabies is associated with overcrowded living conditions, and/or can occur in outbreaks in nursing homes, long-term care facilities, military

2017 NICE Clinical Knowledge Summaries

88. Practice Parameters for the Management of Clostridium Difficile Infection

hands after each patient encounter. 67 a lcohol hand rubs are commonly used and can be used in conjunction with gloves for avoidance of contamination, as well as soap and water every few hand-cleansing sessions. h owever, for any potential contamination, alcohol hand rubs are insuf- ficient, because they do not kill spores and therefore should not be used alone to decontaminate hands. 67–69 in addition to diligent hand hygiene with warm water and scrubbing, when providing care for patients with C (...) . appropriate cleaning of rooms vacated by patients and equipment used on patients with C difficile is required. s odium hypochlo- rite solutions have proven efficacy in decontaminating surfaces. 72,73 identification of asymptomatic chronic colonization with C difficile occurs in ~8% to 20% of patients admitted to the hospital, 74,75 and up to 50% (2.1%–51%) of patients in rehabilitation and long-term care facilities. 76–80 t his rate increases with factors such as recent hospitalization, recent antibiotic

2015 American Society of Colon and Rectal Surgeons

89. Acute Pain Management: Scientific Evidence

Paediatric pain assessment 412 9.3.1 Pain assessment in neonates 413 9.3.2 Observational and behavioural measures in infants and children 414 9.3.3 Self-report in children and adolescents 415 9.3.4 Children with cognitive impairment or intellectual disability 416 9.4 Analgesic agents 421 9.4.1 Paracetamol 421 9.4.2 Nonselective NSAIDs 424 9.4.3 Coxibs 429xix CONTENTS 9.4.4 Opioids and tramadol 430 9.4.5 Ketamine 438 9.4.6 Alpha-2-delta ligands (gabapentin/pregabalin) 440 9.4.7 Alpha-2 adrenergic agonists (...) 441 9.4.8 Corticosteroids 443 9.5 Opioid infusions and PCA 444 9.5.1 Opioid infusions 444 9.5.2 Patient-controlled analgesia 445 9.5.3 Nurse-controlled analgesia 447 9.5.4 PCA by proxy 447 9.5.5 Overall safety of parenteral opioid use in children 448 9.6 Regional analgesia 449 9.6.1 Continuous and single-injection peripheral nerve blocks 449 9.6.2 Neuraxial blocks 453 9.6.3 Topical therapies 464 9.7 Management of procedural pain in children 465 9.7.1 Procedural pain in the neonate 466 9.7.2

2015 Clinical Practice Guidelines Portal

90. Guidelines for caring for an infant, child, or young person who requires enteral feeding

……………………………………………………………………………………………………………………………………..34 APPENDIX 4……………………………………………………………………………………………………………………………………..35 APPENDIX 5 36 REFERENCES 37 LITERATURE SEARCH 41 EQUALITY SCREENING 42 GUIDELINE DEVELOPMENT GROUP 43 3 Preface There are a large number of children and young people in settings such as hospitals, homes, schools and respite facilities, who require various enteral feeding regimes to achieve effective nutrition. Enteral feeding can have a big impact on family life resulting in both psychological and practical problems which should (...) be addressed regularly. Multi professional teams provide support to ensure the safe and effective management of all aspects involved with enteral feeding. It is therefore essential that all staff, families and carers have the necessary knowledge and skills to provide safe, effective, person centred care. GAIN has identified the need to develop guidelines. The objective is to ensure that a consistent approach is provided for the management of enteral devices in children and young people across all Health

2015 Regulation and Quality Improvement Authority

91. Tourniquet: surgical

drapes are applied ( ). The use of an adhesive occlusive dressing should not be used on children suffering from epidermolysis bullosa ( ). Avoid over prepping of the required surgical area ( ). If the limb is elevated during prepping ensure any excess prep solution that comes in contact with the tourniquet is dried prior to draping ( ). Attach the tubing to the correct pressure regulator on the tourniquet machine, ie the left inflation tubing from the left cuff is attached to the left pressure (...) regulator. Exsanguinate the limb by using one of the following methods ( ): an Esmarch bandage a roll cylinder limb elevation prior to inflation ( ) If an Esmarch bandage is to be used it should be applied from the extremity tip towards the tourniquet cuff. The bandage should overlap by 2.5 cm (1 inch) and continuous pressure must be applied during application ( )( ). An Esmarch bandage should not be used on children suffering from epidermolysis bullosa, the limb should be elevated instead ( ). During

2015 Publication 1593

93. Clinical Practice Guideline: The Diagnosis, Management, and Prevention of Bronchiolitis

: B; Recommendation Strength: Moderate Recommendation). 11a. All people should disinfect hands before and after direct contact with patients, after contact with inanimate objects in the direct vicinity of the patient, and after removing gloves (Evidence Quality: B; Recommendation Strength: Strong Recommendation). 11b. All people should use alcohol-based rubs for hand decontamination when caring for children with bronchiolitis. When alcohol-based rubs are not available, individuals should wash (...) see: Abstract This guideline is a revision of the clinical practice guideline, “Diagnosis and Management of Bronchiolitis,” published by the American Academy of Pediatrics in 2006. The guideline applies to children from 1 through 23 months of age. Other exclusions are noted. Each key action statement indicates level of evidence, benefit-harm relationship, and level of recommendation. Key action statements are as follows: Abbreviations: AAP — American Academy of Pediatrics AOM — acute otitis media

2014 American Academy of Pediatrics

94. Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections

or abscesses who have failed initial antibiotic treatment or have markedly impaired host defenses or in patients with SIRS and hypotension (severe; Figure and Table (strong, low). Table 2. Antimicrobial Therapy for Staphylococcal and Streptococcal Skin and Soft Tissue Infections Disease Entity Antibiotic Dosage, Adults Dosage, Children a Comment Impetigo b ( Staphylococcus and Streptococcus ) Dicloxacillin 250 mg qid po N/A N/A Cephalexin 250 mg qid po 25–50 mg/kg/d in 3–4 divided doses po N/A Erythromycin (...) by MRSA Linezolid 600 mg every 12 h IV or 600 mg bid po 10 mg/kg every 12 h IV or po for children <12 y Bacteriostatic; limited clinical experience; no cross-resistance with other antibiotic classes; expensive Clindamycin 600 mg every 8 h IV or 300–450 mg qid po 25–40 mg/kg/d in 3 divided doses IV or 30–40 mg/kg/d in 3 divided doses po Bacteriostatic; potential of cross-resistance and emergence of resistance in erythromycin-resistant strains; inducible resistance in MRSA. Important option for children

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2014 Infectious Diseases Society of America

95. Bronchiolitis

90%. Continuous pulse oximetry is optional for infants and children with bronchiolitis. Chest physiotherapy should not be used in the management of bronchiolitis. Palivizumab prophylaxis should be administered during the first year of life to infants with hemodynamically significant heart disease or chronic lung disease of prematurity (<32 weeks gestation who require >21% O 2 for the first 28 days of life). To prevent spread of respiratory syncytial virus (RSV), hands should be decontaminated (...) of disease severity should be based on history and physical examination. Laboratory and radiologic studies should not be routinely ordered for diagnosis. Risk factors for severe disease such as age < 12 weeks, premature birth, underlying cardiopulmonary disease, or immunodeficiency should be assessed when making decisions about evaluation and management of children with bronchiolitis. Bronchodilators (albuterol, salbutamol), epinephrine, and corticosteroids should not be administered to infants

2014 American Academy of Family Physicians

96. Xpert MTB/RIF implementation manual

Resistance by Use of On-Demand, Near-Patient Technology. Journal of Clinical Microbiology, 2010 48: 229–237. 2 Automated real-time nucleic acid amplification technology for rapid and simultaneous detection of tuberculosis and rifampicin resistance: Xpert MTB/RIF system for the diagnosis of pulmonary and extrapulmonary TB in adults and children: policy update. Geneva, World Health Organization, 2013 (available at http://www.who.int/tb/laboratory/policy_statements/en/)XPERT MTB/RIF IMPLEMENTATION MANUAL 1 (...) . 12XPERT MTB/RIF IMPLEMENTATION MANUAL 3 2.4 Summary of WHO’s 2013 policy recommendations 2.4.1 Using Xpert MTB/RIF to diagnose pulmonary TB and rifampicin resistance in adults and children • Xpert MTB/RIF should be used rather than conventional microscopy, culture and DST as the initial diagnostic test in adults suspected of having MDR-TB or HIV-associated TB (strong recommendation, high-quality evidence). • Xpert MTB/RIF should be used rather than conventional microscopy, culture and DST

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2014 World Health Organisation Guidelines

97. Hand hygiene

of infection ( ). However, studies on hand hygiene compliance among healthcare workers have repeatedly shown poor compliance with hand hygiene ( ). The Trust is committed to increasing and maintaining hand hygiene compliance and is actively promoting education programmes on hand hygiene. Hand hygiene compliance is audited trust wide on a monthly basis. Parents and children/young people should be taught the importance of good hand hygiene in the home environment as well as in hospital. Types of hand hygiene (...) procedures Routine/social hand wash Why should a routine/social hand wash be performed? A routine/social hand wash is performed to remove transient microorganisms and to render the hands socially clean. This level of decontamination is sufficient for general social contact and most clinical care activities ( ) ( ). When should a routine/social hand wash be performed? The occasions when hand hygiene should be performed have been summarised into the ‘5 Moments for Hand Hygiene' document

2014 Publication 1593

98. Breast milk: expressing and handling

Breast milk: expressing and handling Breast milk: expressing and handling | Great Ormond Street Hospital Google Tag Manager Navigation Search Search You are here Breast milk: expressing and handling Breast milk: expressing and handling Introduction Breastfeeding has significant short and long term benefits on the health of the mother and baby beyond the period of breastfeeding itself ( ). Supporting women to breastfeed will improve the quality of life for women and for children through reducing (...) or illness, some mothers cannot begin breastfeeding immediately or continue to breastfeed. They should be encouraged to start expressing their breast milk 8 to 10 times in every 24 hours to establish and maintain a good breast milk supply ( ). Occasionally there are instances when breast feeding is contra-indicated. These include mothers who are: Taking some medications. The British National Formulary for Children (BNF) gives advice about most drugs in common use, or contact Pharmacy for advice

2014 Publication 1593

99. Aseptic non touch technique (ANTT) for intravenous therapy

focus of ANTT® is to minimise the introduction of micro-organisms, which may occur during preparation, administration and delivery of IV therapy. In order to further reduce the potential for contamination, the technique follows some fundamental rules pertaining to infection control and staff/patient protection such as effective handwashing, the wearing of non-sterile gloves, the principles of key parts/sites and the use of alcohol-based solutions for decontamination with adequate cleaning (...) fingernails, nor too large, as they may impede manual dexterity ( ). Cleaning IV trays Correct decontamination of the IV trays is an essential part of the process. After the IVs have been administered, the IV trays are decontaminated as follows: Prior to use, the tray needs to be disinfected with a 70% alcohol wipe (eg Sani-Cloth70) and allowed to dry naturally. After use and prior to leaving the patient's bedspace or room, the outside of the tray must be decontaminated with a sanitising wipe (eg Clinell®

2014 Publication 1593

100. Aseptic technique in theatre

a new sterile field. Rationale 21: The records kept for the decontamination process should be able to prove retrospectively that the instrument has passed through each stage of the sterilisation process. Records need to be kept for traceability purposes . Rationale 22: To prevent personal shedding over the sterile field. The average individual sheds an estimated 4000 to 10,000 viable contaminated particles from the skin per minute. The major areas of microbial shedding include the head, neck (...) 2020 Document version: 2.5 Previous version: 2.4 Policies and legal statements Follow Us Great Ormond Street Hospital Tel: 020 7405 9200 Great Ormond Street Hospital for Children NHS Foundation Trust Great Ormond Street London WC1N 3JH © 2019, Great Ormond Street Hospital for Children NHS Foundation Trust

2014 Publication 1593

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