OPAT-Cellulitis

 

Often patients with cellulitis, need more than oral antibiotic management. However, they are not so sick to require hospital admission. OPAT allows suitable patients to be managed through the ambulatory services rater than being admitted.

Inclusion Criteria:

  • Cellulitis requiring intravenous therapy
  • > 16yrs old

Exclusion Criteria:

  • NEWS ≥ 4 OR Red Flag Sepsis
  • Acute Confusion
  • Oxygen requirements
  • MRSA positive Hx – as will need Vancomycin
  • Unable to manage at home / Return to AAU
  • Has a concurrent issue requiring admission
  • IVDU so unable to be sent home with Cannula in situ

Discharge Planning:

  • Investigations – Ensure an FBC & U&E have been sent to lab (you don’t need to wait for results) for AAU to add on tests as needed
    • Process the POCT FBC (Sysmex), POCT U&E (IStat) and VBG in ED and document the results in the notes to allow AAU to give 1st dose of Antibiotics
    • Document the patients weight
  • Antibioticsas per pathway – ensure paper prescription is completed and sent to AAU
  • AAU open 08:00-20:00
    • Transfer to AAU for AAU team to give 1st dose of antibiotics on OPAT pathway.
  • AAU closed 20:00-08:00
    • IV cannula – consider how appropriate it is to remain in.
    • Give 1st dose of antibiotics in ED then discharge to return to AAU for subsequent doses – ensure patient does not return to early for their next dose!
    • Ensure AMU Co-Ordanator has all patient details and paper prescription
    • Patient to return to AAU when next open, to start OPAT pathway

AAU may need to phone patient to arrange an appropriate time make sure the patients phone number is correct!

 

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