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Decontamination in Children

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121. 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

122. 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

124. 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

125. 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 Publication 1593

126. Methicillin-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

2013 Publication 1593

127. 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

128. 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

129. 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

130. 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

131. 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

132. 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

133. 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

134. 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

136. 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

137. Best practices for injections and related procedures toolkit

also be transmitted through blood, but require large volumes, such as are found in a blood transfusion. Infections transmissible by blood transfusion are covered in other documents on blood safety. 1.4.1 Hepatitis B virus Newly acquired HBV infection is often asymptomatic – only 30–50% of children over 5 years of age and adults have initial clinical signs or symptoms (12, 13).The fatality rate among people with reported cases of acute symptomatic hepatitis B is 0.5–1.0 (13). Chronic HBV infection (...) develops in about 90% of those infected as infants, 30% of infected children under 5 years of age, and less than 5% of infected individuals over 5 years of age (12, 13). Overall, about 25% of those who become chronically infected during childhood, and 15% of those who become chronically infected after childhood, die prematurely from cirrhosis or liver cancer (12, 13). There is no specific treatment for acute hepatitis B; treatment for chronic infection with HBV is costly and often not available. HBV

2010 World Health Organisation Guidelines

138. CPG on Surgical Patient Safety

areas where surgery is performed. Surgical staff who wear non-sterile clothing should minimise their entries to and exits from the surgical area. Strong It is not recommended that nasal decontamination be used with topical antimicrobial agents to eliminate S. aureus on a routine basis to reduce the risk of SSI. Strong It is not recommended that mechanical preparation of the intestine not be routinely used to prevent SSI. Strong Hands should be washed before and after each episode of direct contact

2010 GuiaSalud

139. CPG on Acute Bronchiolitis

satu- ration monitoring via pulse oximetry indicated? 34. In patients with acute bronchiolitis, when is continuous or occasional CO 2 moni- toring (transcutaneous or exhaled) indicated? 35. In patients with acute bronchiolitis, when is monitoring of BR, HR and a clinical severity scale indicated? 36. In patients with acute bronchiolitis, when is apnoea monitoring indicated? PREVENTION 37. In children aged under 24 months, are anti-RSV monoclonal antibodies useful in preventing the onset (...) hospital transmission of RSV and other respiratory viruses? 41. In patients with acute bronchiolitis, what is the relationship between maternal smoking during pregnancy and passive exposure of children to tobacco smoke and the incidence and severity of the illness? 42. In patients with acute bronchiolitis, what is the relationship between breastfeeding and the incidence and severity of the illness? 43. In patients with acute bronchiolitis, what is the relationship between prematurity, birthweight

2010 GuiaSalud

140. The 3M Tegaderm CHG IV securement dressing for central venous and arterial catheter insertion sites

for central venous and arterial catheter insertion sites (MTG25) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 5 of 34Reduced material and staff costs for treatment of catheter-related infection. Current management 2.6 NICE's guideline on infection provides guidance on using dressings in adults and children with vascular access devices (central venous catheters or peripherally-inserted central catheters) in primary (...) and community care settings. The guideline recommends that the skin at the central venous catheter insertion site, and the surrounding skin during dressing changes, should be decontaminated with CHG in 70% alcohol and allowed to air dry. If the company's recommendations prohibit the use of alcohol with their catheters, an aqueous solution of CHG should be considered. The guideline further recommends using a sterile, transparent semipermeable membrane dressing to cover the vascular access device insertion

2015 National Institute for Health and Clinical Excellence - Medical technologies

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