Category: Medical

Measles

Suspected/Confirmed patients should be ISOLATED & wear PPE 

Treating Staff – (should not be; non-immunised, pregnant or immunocompromised)

  • single-use, disposable gloves
  • single-use, disposable apron (or gown if extensive splashing or spraying, or performing an aerosol generating procedure (AGP))
  • FFP3 – respiratory protective equipment (RPE)
  • eye/face protection (goggles or visor)

Patient

  • Surgical face mask

Background

  • Measles is highly infectious – (4 day prior to and after rash appears) suspected patients should be isolated within the ED
  • Measles Immunisation – 1 dose 90% effective, 2 doses 95% effective
  • Measles is a notifiable disease
EM3

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Medical SDEC

Note: If the referrer feels the presentation of a patient is not within the inclusion/exclusion criteria they can still contact the SDEC co-ordinator and check for acceptance into SDEC.

  • ED referrals ONLY 08-18:00
  • Check Capacity prior to sending
  • Investigations: FBC/U&E/Clotting/ECG

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NIV (Non Invasive Ventilation)

NIV should be considered for use in patients with a  persisting Acute Hypercapnic Respiratory Failures after a maximum of one hour of standard medical therapy.

  • Complete the Ad-hoc form
  • Increase pressures from Initial 12/5 cmH2O to 20/5cmH2O – as tolerated over 1st hour

However, ICU should be contacted early if the patient has one of the following:

  • Asthma – Intubation the option of choice in Life threatening
  • Pneumonia – NIV should only be considered as a bridge to intubation
  • No pre-exisiting respiratory issue – NIV not likely helpful
  • pH <7.25 (low threshold for ICU input)
  • pCO2 >6.5kPa (low threshold for ICU input)
  • Type 1 Respiratory Failure (low threshold for ICU input)

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Acidosis & VBG’s

We are frequently asked to check the lactate on Venous Blood Gases (VBG’s), by the nursing staff. However, remember to look at the first result (pH) it is the most important.

Acidosis: Unless you have a good reason (e.g. you know its due to DKA) you should be investigating and performing an Arterial Blood Gas (ABG)

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