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Decontamination in Children

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102. Infection: management of outbreaks, including diarrhoea and vomiting

. Additional appropriate staff may be drawn from: Consultant – Communicable Diseases Control (HPU) Consultant and Nurse Manager from the Occupational Health department Bed Managers Catering Manager or Deputy – if associated with food or water Chief Dietician or Deputy – if associated with food or water Director of Estates or Deputy – if associated with water, air conditioning, sewage or environment Head of Decontamination – if associated with sterilisation or disinfection Medical Director Divisional (...) 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

103. Infant feeding: formula

. Please note: re-usable teats must be decontaminated in microwave sterilising bags available from the ward in accordance with the manufacturer’s instructions . Check the temperature of the feed before giving it to the baby, by shaking a few drops of feed onto the inside of your wrist . Feeding the baby Make sure that both you and the baby are comfortable. Loosen or remove some of the baby’s clothing if necessary . Hold the baby securely . Only remove the bottle cap and screw on the teat immediately (...) a baby alone with a bottle . Once the feed has been warmed and the teat attached, it must be used within one hour. Any unused feed must be discarded . Vitamin supplements A daily vitamin D supplement should be given to all breast-fed infants and all infants having less than 500ml of formula . Please note: Sick babies (including premature babies) and children may have different vitamin requirements depending on their underlying condition. Check with your ward dietitian . Rationale Rationale 1

2014 Publication 1593

104. Surgical diathermy

. A high level of patient dignity must be upheld at all times. Patient positioning devices should be placed under the return electrode mat where applicable. The return electrode mat should not be folded whist in place during surgery or at the end of the list. Storage of the mat should follow manufacturer's guidelines. If the return electrode mat is faulty or broken, it must not be used. It should be decontaminated and sent to the biomedical engineering department. The return electrode mat should (...) not be used on children suffering from epidermolysis bullosa. A return electrode mat or bipolar electrosurgery should be used instead ( ). The power setting should be confirmed verbally between the operator and the user before activation. The power settings are determined in conjunction with the manufacturers written recommendations, patient size and type of procedure ( )( ), It is the responsibility of the surgeon to activate the active electrode ( ). Staff should check the entire ESU circuit

2014 Publication 1593

105. 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

2014 Publication 1593

106. Nasopharyngeal airway (NPA)

is to be sized correctly in patients: if the airway is too short it will fail to separate the soft palate from the pharynx and if too long it can pass into the larynx and aggravate cough and gag reflexes ( ). The NPA primarily acts as a 'splint' which maintains patency of the airway, or keeps the tongue from falling back on the posterior pharyngeal wall and occluding the airway, therefore preventing airway obstruction, hypoxia and asphyxia ( ). NPAs are generally well tolerated by conscious children (...) and are used in the management of children with congenital maxillofacial abnormalities, syndromic craniosynotosis, mid-facial hypoplasia or to support the upper airway post trauma or surgery ( ). Note: While the term 'child' is used throughout this guideline, all procedures are also applicable to young people. Indications for a NPA Indications for a NPA itself and the length required to relieve the obstruction must be determined on an individual basis for each child. Pierre Robin Sequence The child

2014 Publication 1593

107. STaph Aureus Resistance-Treat Early and Repeat (STAR-TER)

, Chapel Hill Collaborators: University of Washington Cook Children's Medical Center Indiana University National Jewish Health University of Michigan University of Texas Southwestern Medical Center St. Louis Children's Hospital Information provided by (Responsible Party): University of North Carolina, Chapel Hill Study Details Study Description Go to Brief Summary: To evaluate the micro-biologic efficacy and safety of a streamlined treatment for early onset methicillin-resistant staphylococcus aureus (...) (MRSA) in patients with cystic fibrosis. Condition or disease Intervention/treatment Phase Cystic Fibrosis Drug: Trimethoprim Sulfamethoxazole (TMP/SMX) Drug: Minocycline Drug: Mupirocin Drug: Chlorhexidine Gluconate Behavioral: Environmental Decontamination Phase 2 Detailed Description: This is an open-label, multi-center interventional trial in Cystic Fibrosis (CF) patients with new MRSA isolated from the respiratory tract (oropharyngeal (OP) = OP swab, sputum, or bronchoscopy) at a clinical

2018 Clinical Trials

108. Foodborne intestinal protozoan infection and associated factors among patients with watery diarrhea in Northern Ethiopia; a cross-sectional study (PubMed)

Foodborne intestinal protozoan infection and associated factors among patients with watery diarrhea in Northern Ethiopia; a cross-sectional study Intestinal protozoa are parasites transmitted by consumption of contaminated water and food and mainly affect children and elder people and cause considerable health problems. They are the leading causes of outpatient morbidity due to diarrhea in the developing countries. So, assessing water and food source of diarrheal patients and identifying (...) type of recipe to decontaminate salads and fruits (AOR = 2.64, 95 CI: 1.34-5.19, P = 0.005) and using vinegar as a decontaminant (AOR = 2.83, 95 CI: 1.24-6.48, P = 0.014). Eating out (meals at a restaurant) on the other hand was found to be protective for foodborne protozoan infection (AOR = 0.43, 95 CI: 0.23-0.78, P = 0.006).Our study revealed that foodborne protozoa infections are of public health significance in the study area. Vinegar, which is frequently used as a recipe for decontaminating

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2018 Journal of health, population, and nutrition

109. Clinical Guidelines and 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 Royal College of Surgeons of England

110. Amitraz, an underrecognized poison: A systematic review. (PubMed)

of decontamination methods, namely, gastric lavage and activated charcoal was unclear.Our review shows that amitraz is an important agent for accidental or suicidal poisoning in both adults and children. It has a good prognosis with supportive management. (...) children) of human poisoning with amitraz were included in this systematic review. The most commonly reported clinical features of amitraz poisoning were altered sensorium, miosis, hyperglycaemia, bradycardia, vomiting, respiratory failure, hypotension and hypothermia. Amitraz poisoning carried a good prognosis with only six reported deaths (case fatality rate, 1.9%). Nearly 20 and 11.9 per cent of the patients required mechanical ventilation and inotropic support, respectively. The role

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2017 The Indian journal of medical research

111. Briefs: Cyanide poisoning

Briefs: Cyanide poisoning Briefs: Cyanide poisoning – PEMBlog Search for: Search for: Briefs: Cyanide poisoning The most common scenario in which providers should be concerned about cyanide poisoning in children is in a patient rescued from a structure fire. Cyanide is released from things that burn within a home (wood, fabrics etc,.) and is inhaled. Poisoning essentially results in disruption of the electron transport chain, resulting in depletion of ATP. Therefore you can’t do aerobic (...) , they should present with: Exposure to fire smoke in an enclosed area Soot present around mouth, nose or oropharynx Altered mental status Supportive labs include an elevated lactate (>8 is bad) Patients exposed to smoke only need decontamination of hair (wash it) and remove outer clothing. Ideally the sooner the better. Severe exposures lead to death – but Cyanokits should be given at the scene if possible. This is done in Europe for instance. How do we dose it? Pediatric patient – 70mg/kg IV (max 5g

2017 PEM Blog

112. Bioterrorism: 10 facts about sarin gas

Bioterrorism: 10 facts about sarin gas Bioterrorism: 10 facts about sarin gas Bioterrorism: 10 facts about sarin gas | | April 8, 2017 90 Shares As the civil war in Syria shows no signs of de-escalating, worrisome evidence points towards the deployment of chemical warfare with banned agents recently, resulting in almost a hundred deaths with more than a quarter of them children. Chlorine and Sarin gas are primarily being implicated. Here are ten facts to know about Sarin gas and how it works. 1 (...) . Sarin is heavier than air and sinks to lower levels over the ground. Children are more susceptible to Sarin because they are closer to the ground, have smaller bodies, faster breathing rates, immature organ systems, and . 5. Sarin gas is more potent than liquid and symptoms appear within seconds of exposure to the gas but may take hours with the liquid form. Since it is odorless, victims are unaware of its presence, just like carbon monoxide. Deaths are mostly due to respiratory failure from

2017 KevinMD blog

113. Briefs: Beta Blocker Overdose

of 100 mm Hg and a minimal heart rate of 50 beats per minute.It can take up to 15-60 minutes to see improvements. You’ll want to check blood glucose (every 30-60 minutes) and serum potassium (hourly) frequently. GI decontamination may be indicated in severe cases. Activated charcoal may help in long acting/sustained release agents. You can use whole bowel irrigation in these situations as well. remember gastric stasis occurs in Beta Blocker overdoses so pills can sit in the stomach longer. Other (...) Sobolewski, MD, MEd is an Associate Professor of Pediatric Emergency Medicine and an Assistant Director for the Pediatric Residency Training Program at Cincinnati Children's Hospital Medical Center. He is on Twitter @PEMTweets and authors the Pediatric Emergency Medicine site PEMBlog. All views are strictly my own and not official medical advice. Related Posts October 11th, 2018 July 12th, 2018 June 14th, 2018 May 10th, 2018 February 15th, 2018 December 14th, 2017 November 30th, 2017 October 26th, 2017

2017 PEM Blog

114. Central Venous Access in Oncology

/vte.pdf[62,135,136]. Volume26 | Supplement5 | September2015 doi:10.1093/annonc/mdv296 | v??? AnnalsofOncology clinicalpracticeguidelines? Implementationofbundledstrategies,includingdocumenting and reporting rates of compliance of all components of the bundle,asbenchmarksforqualityassuranceandperformance improvement. ? Implementation of appropriate patient education programmes, which include instructions on hand decontamination and the prevention of cross-contamination in patients with stomas [1, 2 (...) ]. Itisroutine practice to?ushtunnelled cuffed catheters and PICC linesweekly,andsubcutaneousports4-weekly(whennotinuse), using heparin or normal saline 0.9% solution. An aseptic tech- nique by hospital-trained nurses, which includes the use of alco- holic chlorhexidine 2% cleanser, to decontaminate catheter hubs beforeuse,shouldbeused[37,92]. Thereisemergentevidencethatthenewgenerationofneedle- less connectors, which have mechanical valves that generate negative, positive or neutral pressure during

2015 European Society for Medical Oncology

115. Contaminated fingers: a potential cause of Chlamydia trachomatis-positive urine specimens (PubMed)

surrogate specimens were subjected to C. trachomatis assay and quantification in a real-time PCR-based diagnostic system.The amplimer crossing point (Cq) for EB dilutions was 10.0±1.6 less than for corresponding finger contacted urine specimens, which corresponds to ~10 µL of EB suspension transferred. This was largely independent of participant identity, C. trachomatis strain or EB dilution. Hand decontamination led to large reductions in EBs transferred, but transfer remained consistently detectable (...) . Recent Cq data from C. trachomatis-positive clinical urine specimens were collated, and 20% clearly contained sufficient C. trachomatis to detectably contaminate another specimen by finger-mediated transfer, as in this experiment.This study directly demonstrated the potential for urine contaminated fingers to convert a C. trachomatis-negative urine specimen to C. trachomatis positive as a result of contact. Accordingly, procedures for urine specimen collection, particularly from children, need

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2017 Sexually transmitted infections

116. 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

117. 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

118. 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

119. 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

120. 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

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