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Decontamination in Children

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101. Staphylococcus aureus colonisation in patients from a primary regional hospital (PubMed)

revealed differences in the resistance of methicillin-sensitive, MRSA and MORSA strains. On the whole, our study demonstrates the pattern of distribution of nasal and pharyngeal colonisation with SA, MRSA and MORSA in adults vs. children, inpatients vs. outpatients, ICU patients vs. non‑ICU patients, and females vs. males, which can be used for adjusting the screening and decontamination protocols in a hospital. SA is a pervasive pathogen with constantly changing trends in resistance and epidemiology

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2017 Molecular medicine reports

102. Emergency Management of a Victim who has Been Poisoned

. Speed of effect is determined by the nature of the poison, its concentration, and the time of exposure. ? It is important to seek medical assessment or advice after significant exposure to a poison, even if symptoms are initially mild or absent. MANAGEMENT The principles of managing a patient who has been poisoned are: ? Prevention of poisoning of the rescuer. ? Decontamination of the patient. ? Resuscitation and supportive care, using the Australian Resuscitation Council and New Zealand (...) . ? If more than one person simultaneously appears affected by a poison, there is a high possibility of dangerous environmental contamination. ? The rescuer may need to wear personal protective equipment (PPE) during decontamination and resuscitation. The need for PPE will be guided by knowledge of the likely poison. If equipment is not available to safely decontaminate and treat a victim, rescue may not be possible. [Class A; LOE Expert Consensus Opinion ] 2. Decontamination ? Separate the victim from

2011 Australian Resuscitation Council

103. Guidelines for the Clinical and Operational Management of Drug-Resistant Tuberculosis

- tant to chemical decontamination (with, for instance, sodium hydroxide and detergents). M. tuberculosis is resistant to cold (remaining viable for weeks at 4°C) but susceptible to heat, sunlight, UV light and X-rays. Slow- growing, with generation times ranging from 13 to 20 hours, M. tuberculosis is preferential aerobic, and its growth rate is highly affected by oxygen con- centrations. M. tuberculosis replicates rapidly in cavitary lesions of lung pa- renchyma where oxygen concentration is high

2013 International Union Against TB and Lung Disease

104. Vascular device insertion and lumbar puncture: skin preparation

available within the Trust and contains 2% Chlorhexidine and 70% isopropyl alcohol. Chloraprep® is not licensed by the Medicines and Healthcare products Regulatory Agency (MHRA) for use on infants below the age of two months. The Trust recognises the MHRA’s position and has concluded that the use of Chloraprep® will be used for skin decontamination prior to device insertion, on all children with intact skin including those below 32 weeks gestation and less than two weeks of life ). Although strict (...) by manufacturer Carefusion ( ). Rationale 10: Skin contamination can occur as a result of re-palpating the skin after cleansing. Therefore re-cleansing will be required to sufficiently decontaminate area ( ). References Carefusion (2010a) [last accessed 12.08.15] Carefusion (2010b) [last accessed 15.10.15] Chesshyre, E., Goff, Z., Bowen, A. and Carapetis, J. (2015) The Prevention, Diagnosis And Management Of Central Venous Line Infections In Children. The Journal of infection. Jun;71 Suppl 1:S59-75 . EMA/PRAC

2013 Great Ormond Street Hospital

105. Clinical Practice Guidelines for Antimicrobial Prophylaxis in Surgery

be expected to be quite small with single-dose antibiotic prophylaxis. Although the use of fluoroquinolones may be necessary for surgical antibiotic prophylaxis in some children, they are not drugs of first choice in the pediatric population due to an increased incidence of adverse events as compared with controls in some clinical trials. k Ceftriaxone use should be limited to patients requiring antimicrobial treatment for acute cholecystitis or acute biliary tract infections which may not be determined (...) antibiotic prophylaxis in some children, they are not drugs of first choice in the pediatric population due to an increased incidence of adverse events as compared with controls in some clinical trials. k Ceftriaxone use should be limited to patients requiring antimicrobial treatment for acute cholecystitis or acute biliary tract infections which may not be determined prior to incision, not patients undergoing cholecystectomy for noninfected biliary conditions, including biliary colic or dyskinesia

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2013 Infectious Diseases Society of America

106. Mould Remediation Recommendations

and discarded; they cannot be effectively cleaned. • Porous materials that are surface-contaminated with dust or mould spores only, but do not contain mould growth, can be decontaminated by HEPA vacuuming, if dry. If wet, materials should be professionally cleaned. Items that have been wet for extended periods of time are best discarded to prevent further spread of mould. 3,20 • Semi-porous materials with mould growth, such as wood, can be surface cleaned by a combination of scraping, scrubbing, and HEPA (...) Environ. 2008;399(1-3):19-27. 9. Kercsmar CM, Dearborn DG, Schluchter M, Lintong X, Kirchner HL, Sobolew ski J, et al. Reduction in asthma morbidity in children as a result of home remediation aimed at moisture sources. Environ Health Perspect. 2006;114(10):1574-80. 10. Klitzman S, Caravanos J, Belanoff C, Rothenberg L. A multihazard, multistrategy approach to home remediation: results of a pilot study. Environ Res. 2005;99(3):294-306. 11. Rockw ell W. Prompt remediation of w ater intrusion corrects

2013 National Collaborating Centre for Environmental Health

107. Immediate Post-anaesthesia recovery

the principles, issues and factors relating to risk management. Uses knowledge appropriately to eliminate or reduce these risks. Apply manual handling techniques appropriately using available aids. Attend regular updates. Demonstrate safe management of clinical waste, sharps, drugs and chemicals. Use personal protective equipment (PPE) and be aware of infection control principles. Comply with national and local guidance on single-use items and medical device decontamination. 4.2 Understand how to recognise (...) of ethical, legal and professional issues affecting patient care, ensuring appropriate documentation that follows national and local directives. Understands the importance of confidentiality. Awareness of concept of: informed consent in adults and children legal issues relating to patients with learning disabilities or mental health difficulties patient groups including Jehovah's Witnesses and advance patient directives. Adhere to the NMC and HPC codes of conduct. http://www.aagbi.org/sites/default/files

2013 Association of Anaesthetists of GB and Ireland

108. Emergency Dental Care

and a third of children are currently not registered 6 . The provision of advice and care for unregistered patients differs markedly across the country 3 . General dental practices may offer treatment to unregistered emergency patients but are not obliged to do so. As an alternative, treatment might be available at dental access centres run by the community or salaried general dental services. The fragmented nature of emergency dental services and dissatisfaction with the accessibility and variability (...) care, including general dental practitioners, dental nurses, receptionists, and staff within the salaried, community and hospital dental services. It is also considered to be relevant to those responsible for organising emergency dental service provision at a local or regional level, dental policymakers in NHS Boards 1 Introduction3 Emergency Dental Care 1 Introduction and at a national level. The guidance applies to all patients, including adults, children and those with special needs

2013 Scottish Dental Clinical Effectiveness Programme

110. Ascites due to cirrhosis, management

versus risk) and Level (assessing strength or cer- tainty) of Evidence to be assigned and reported with each recommendation (Table 1, adapted from the American College of Cardiology and the American Heart Association Practice Guidelines). 3,4 These guidelines were developed for the care of adult patients with clinically detectable ascites. Although the general approach may be applicable to children, the pediatric database is much smaller and there may be unanticipated differences between adults (...) and children. Patients with ascites detected only by imaging modalities but not yet clinically evident are not dealt with in detail because of the lack of published infor- mation regarding the natural history of this entity. These patients should probably be reimaged after an interval of perhaps 3 months or when the ?uid becomes clinically apparent. Once the ?uid is clini- cally detectable or other signs or symptoms, e. g. pain or fever, develop, paracentesis should be performed and the approach outlined

2013 American Association for the Study of Liver Diseases

111. Effectiveness of practices to reduce blood culture contamination

: allied health personnel, blood, blood specimen collection, catheterization, disinfectants, health personnel, laboratory personnel, phlebotomy as well as these keywords: anti-infective agent, local; antisepsis; blood sampling; blood culture; catheter; contaminants; contamination; costs; disinfection; health care cost(s); healthcare personnel; intravenous catheter; microbiology; paramedical personnel; phlebotomists; phlebotomy team; skin; skin decontamination; quality; and venipuncture. Included (...) Hospital, Brisbane, Queensland Australia; 280 beds; Teaching hospital 44 months (01/1998 - 08/2002) Venipuncture: 2.6% Catheter: 13% OR = 5.60 (CI: 3.61 – 8.69) Norberg 2003 - Good - Substantial 4,108 total blood cultures – pediatric emergency department Catheter: 2108 Venipuncture: 2000 Children’s Hospital Medical Center of Akron, Akron, OH 12 months (01/1999 - 12/1999) Venipuncture: 2.8% Catheter: 9.1% OR = 3.46 (CI: 2.55 – 4.69) Qamruddin et al. (2007) - Fair - Moderate 1,138 total blood culture

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2012 Laboratory Medicine Best Practices

112. SNMMI Procedure Standard for Therapy of Thyroid Disease with 131I (Sodium Iodide) 3.0

, Ohio; 2 Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; 3 Beaumont Health System, Royal Oak, Michigan; 4 Guy’s Hospital, London, United Kingdom; 5 Columbia University Medical Center, New York, New York; 6 Cincinnati Children’s Medical Center, Cincinnati, Ohio; 7 New York–Presbyterian/Weill Cornell Medical Center, New York, New York; 8 University of Southern California, Los Angeles, California; 9 University of California at Los Angeles, Los Angeles, California; 10 Vanderbilt (...) to prolongation of hy- perthyroidism with adverse clinical sequelae. The 131 I activity used in children in MBq/g of thyroid tissue is similar to that used in adults. An administered 131 I activity toward the upper endofthisrangeorevenhigherisespeciallysuitable for patients with nodular goiters, very large toxic diffuse goiters, and repeated therapies (8), as well as for patients with rapid iodine turnover, such as when 4-h iodine uptake exceeds 24-h uptake. Empiric rather than calculated dosage strategies

2012 Society of Nuclear Medicine and Molecular Imaging

113. Cleaning, disinfection, and sterilization at PSEs

(inflammation of the colon) reportedly has been induced by glutaraldehyde disinfectant residual on endoscopes. 13 Public health inspectors may work with operators to review the disinfection products at PSEs to ensure there is adequate equipment, storage area, and physical space to prevent health hazards from occurring when using or handling a product. Furthermore, these chemicals should be stored in areas only accessible to staff (e.g., away from non-employees or children). To protect themselves (...) , and copper. 19 • Alcohol (60-95%) can damage rubber and plastic. 3 • Iodophors may corrode metals as well as stain synthetic materials. 4 Sterilization Sterilization is a level of disinfection that involves the complete destruction of all microorganisms, including bacterial endospores. 3,5 This high level of decontamination requires specialized equipment and vigilant monitoring to maintain efficacy. Methods include the use of high temperature steam/dry air under pressure (autoclave), ethylene oxide gas

2012 National Collaborating Centre for Environmental Health

114. Clandestine Amphetamine-Derived Drug Laboratories: Remediation Guidelines for Residential Settings

for methamphetamine a Due to similarities between the chemical properties of ecstasy and methamphetamine, this document recommends similar cleanup methods be followed for both compounds. (meth) lab cleanup in the United States, 1 New Zealand, 2 and Australia. 3 • This document is intended for use by public health officials, municipal agencies, law enforcement agencies, and property owners to address decontamination of former drug labs. Background The illegal manufacturing of amphetamine- derived drugs (...) or steam cleaning. 1-3 It is possible that even after thorough cleaning of carpets and other porous materials, residue will remain and porous fabrics will need to be discarded. Residual contaminants on carpets could provide a source of exposure for toddlers and young children, so it is important that these be removed if still contaminated. Floors must be HEPA vacuumed following the removal of carpets. 6. Non-porous surfaces Hard interior surfaces such as walls, tile and wood flooring, ceilings

2012 National Collaborating Centre for Environmental Health

115. Syrup of Ipecac

, Ipecac II. Mechanism Induces III. Indications: Gastric Decontamination in poison ingestion Home management only (No role in the Emergency Department or Clinic) Not recommended for routine use Long anticipated delay to medical care might prompt usage (e.g. rural setting) Only use if directed by Poison control Not recommended for routine use in poison ingestion Does not improve outcome or reduce ER referral If administered, use within 60 minutes of ingestion IV. Advantages Very effective in or V (...) . Contraindications Anticipation of advanced life support in next hour Children under age 6 months s Ingestions with serious aspiration risk Corrosives (acids or bases) Hydrocarbons (Petroleum products) Sharp object ingestion Third trimester of pregnancy Protracted VI. Complications Protracted Ineffective if over 1 hour post-ingestion Delays the administration of charcoal VII. Dose Background Follow or precede with 120 to 240 ml water Do not use in age under 6 months May repeat dose if no in 30 minutes Dose

2018 FP Notebook

116. EVALUATION OF THE CURRENT PRACTICE OF DELIVERING INTRAVENOUS OPIOIDS INFUSIONS IN A UK PAEDIATRIC HOSPITAL. (PubMed)

EVALUATION OF THE CURRENT PRACTICE OF DELIVERING INTRAVENOUS OPIOIDS INFUSIONS IN A UK PAEDIATRIC HOSPITAL. Opiate intravenous infusions are the therapy of choice in severe pain. However, administering infusions to children requires complex dosage calculations, rate adjustments and often multiple manipulations of injectable medicines to obtain the final "ready to use" solution for both continuous infusion and additional boluses; potentially putting children at high risk.1 2 AIM: To investigate (...) the practice and accuracy of healthcare professionals (HCPs) in hospital theatres and wards in preparing morphine infusions for nurse/patient controlled analgesia (N/PCA) use in a UK children's hospital.A mixed methods study in which direct observation of HCPs preparing paediatric morphine infusions for N/PCA in theatres and on wards, focus groups with HCPs and quantitative analysis of morphine concentration in the syringe using UV-Vis Spectrophotometer. The British Pharmacopoeia (BP) reference limits

2016 Archives of Disease in Childhood

117. Clinical Guidelines & Integrated Care Pathways for the Oral Health Care of People with Learning Disabilities

the foundation for professional and service development to address inequities in provision of oral care. Data available on oral health status for children and adults with a learning disability relates mainly to specific groups. However, the overall picture is one of poor periodontal health and a greater than normal unmet need of treatment for children and adults (Shaw et al., 1986, Nunn and Murray, 1987 , Hinchliffe et al., 1988, Thornton et al., 1989, Shaw et al., 1990, Francis et al., 1991, Kendall, 1991 (...) to general well being” (Oral Health Strategy Group, 1994). The term ‘oral health’ includes dental health and will be used throughout this document. Prevalence of Learning Disability It is estimated that there are 1.2 million people with a mild to moderate learning disability living in the UK and approximately 210,000 with a severe or profound disability (Valuing people 2001). More males than females are affected, with about one quarter being children aged under 16. Approximately a quarter of the total

2012 British Society for Disability and Oral Health

118. Surgical site infections: prevention and treatment

Contents Introduction 4 Patient-centred care 6 Key priorities for implementation 7 1 Guidance 9 1.1 Information for patients and carers 9 1.2 Preoperative phase 9 1.3 Intraoperative phase 11 1.4 Postoperative phase 13 T erms used in this guideline 15 More information 16 2 Research recommendations 17 2.1 Nasal decontamination 17 2.2 Maintaining patient homeostasis 17 2.3 Closure methods 18 2.4 Wound dressings 19 2.5 Dressings for wound healing by secondary intention 19 Update information 20 Surgical (...) of antibiotics. Surgical site infections: prevention and treatment (CG74) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 5 of 20P Patient-centred care atient-centred care This guideline offers best practice advice on the care of adults and children to prevent and treat surgical site infection. Treatment and care should take into account patients' needs and preferences. People with, or at risk of, surgical site infections

2008 National Institute for Health and Clinical Excellence - Clinical Guidelines

120. ACR-SNMMI-SPR Practice Guideline for the Performance of Adult and Pediatric Radionuclide Cystography

antegrade excretion [4-6]. Another disadvantage of indirect cystography is that it imparts a higher radiation dose to the patient than direct cystography. Indirect cystography should not be used if the patient is not toilet trained or has compromised renal function [4-7]. Administered activity in children should be determined based on body weight and should be as low as reasonably achievable for diagnostic image quality. VII. SPECIFICATIONS OF THE EXAMINATION The written or electronic request (...) and children refer also to the ACR–SPR Practice Guideline for the Performance of Voiding Cystourethrography in Children. If the retrograde direct technique is used, the radiopharmaceutical is administered aseptically into the bladder via a urinary catheter and followed by an appropriate volume of sterile normal saline, until the bladder reaches capacity. Application of urethral anesthesia for male patients before catheterization may help decrease discomfort [8]. Alternatively, in adults

2010 Society of Nuclear Medicine and Molecular Imaging

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