Author: huw masson

Tetanus – Wounds

Changes in: Tetanus prone and High Risk definitions

Immunisation schedule

  • Primary: 2, 3 & 4 months old
  • Boosters: 3½ – 5yrs and 13-15yrs

Warning:

  • Immunisation only started nationwide in the UK in 1961 (people born before 1961 are unlikely to have completed a primary course)
  • Immunocompromised patients are unlikely to produce adequate antibodies

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Alprostadil

To maintain or restore patency of the ductus arteriosus

Only to be used in infants who are ventilated or where ventilation is immediately available

DO NOT DELAY IN STARTING Alprostadil if: there is clinical
suspicion of duct dependent CHD while waiting for paediatric cardiology opinion OR echocardiogram, even when in-house echo facilities are present.

PDF: Alprostidil

 

Alcohol Withdrawl

Generally we DON’T admit patients acutely solely for “Detox”

However the following groups should be admitted [taken from trust guide]

  • Patients requiring admission for another reason – refer to appropriate specialty (e.g.  Head injury going to CDU, or Upper GI bleed going to medicine)
  • ALL patients with symptoms / signs of Wernicke’s – medicine
  • ALL patients with Delirium Tremens – medicine
  • ALL alcohol withdrawal fits if patient to remain abstinent – medicine
  • ALL alcohol related seizures with possible other trigger – medicnie
  • ALL decompensated alcoholic liver disease – medicine

If admitted to CDU – complete the PAT tool

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Ordering X-Rays from Triage

Be specific

  • Subtle fractures are hard to pick up – especially if the wrong X-Ray is requested. Ordering the right X-Ray helps patients.
  • Finger injury – request X-Ray Finger(specific), NOT a hand (they are different views and often of little use)
  • Wrist injury – request X-Ray Wrist NOT Radius & Ulna
    • You can request they include the distal half of radius and ulna if the pain covers that area but still request a wrist

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