You may have seen in the news early results from the RECOVERY trial.
Covid-19 patients requiring either Oxygen or Intubation, dexamethasone has been shown to reduce mortality.
Oxygen – 20% reduction in mortality
Intubation – 35% reduction in mortality
No respiratory support required – No benefit found
Inclusion: Covid-19 patient requiring oxygen or intubation
Medication: (RECOVERY study protocol)
Dexamethasone administered as an oral (liquid or tablets) or intravenous preparation 6 mg once daily for 10 days.
In pregnancy or breastfeeding women, prednisolone 40 mg administered by mouth (or intravenous hydrocortisone 80 mg twice daily) should be used instead of dexamethasone.
Post Dex Glucose monitoring:
Glucose should be checked every 6hrs (ideally fasted i.e. before meal)
If Glucose ≥12, follow the chart below either guided by their normal Total Daily Dose (TDD) of insulin, or weight if insulin nave, or unknown.
Full protocol – HERE
2 video links to PHE how to Don and Doff your PPE
In our trust we don’t have paediatric critical care beds. However, in our region we use EMBRACE (a paediatric critical care transport team), who can transfer critically ill children to specialist centers (in or out of region).
Y&H Paed Critical Care
Registered Medical Practitioners in England and Wales have a statutory duty to notify Public Health about the following diseases. To facilitate rapid treatment and control of outbreaks.
(Links to Wikipedia for illustrative purposes) Read more
Remember to complete ReACT or CAMHS assessment tools on EPR Read more
guide to the investigation of Metastatic Spinal Cord Compression (MSCC) in Oncology/Haematology patients.
You need to be a bit more suspicious and have a lower threshold for investigation than in patients without Known, Suspected OR Previous Malignancy
Transfusion Care Pathway
When giving blood products you need to use the transfusion care pathway.
It can be found on intranet > Policies & Documents Library >Other Systems [green button] > Clinical records repository > Search [title And transfusion] – its only 9 clicks away (and some writing)