Click here to download the poster
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Running insitu SIM at CHT means we to learn and share our learning
@cazandal, @chftedsim
EMbeds guide on how to manage PE’s here
Click here to download the poster
Click here to view on another tab
Running insitu SIM at CHT means we to learn and share our learning
@cazandal, @chftedsim
EMbeds guide on how to manage PE’s here
Click here to view on another tab
Running insitu SIM at CHT means we to learn and share our learning
@cazandal, @chftedsim
EMbeds pulmonary oedema guidelines
Click here to download the poster
Click here to view on another tab
Running insitu SIM at CHT means we to learn and share our learning
@cazandal, @chftedsim
Q: Why are Smurf’s Blue?
A: Methaemoglobin (MetHb) of course!
– MetHb is produced by oxidisation of the Iron in Haemoglobin (Hb) from Fe2+ to Fe3+
– Fe3+ prevents Hb carrying oxygen (thus produces symptoms of hypoxia)
– Often due to chemical ingestion, but may also be genetic
– Treated with Methyl Blue & supportive measures
Patients with Covid-19 symptoms should have 2 swabs taken immediately
Record result on EPR as “Covid-19 Antigen Lateral Flow – POCT”
Any patients identified by site commander as needing urgent result for flow reasons
(This also includes direct ward admissions to gastro and oncology)
Record result on EPR as “Covid-19 RNA PCR – POCT”
A swab MUST be taken and sent to the lab for PCR testing.
Patient does not wait in ED for result.
NIPPV 3 machines are used throughout the trust to deliver NIV and CPAP – and should be commenced in ED if transfer to ward/ICU is adding significant delay
This video demonstrates how to set up CPAP on the NIPPV 3
The 4C mortality score has been developed by ISARIC[BMJ], based on 35.463 UK Covid-19 patients.
If cases climb prognostication may become more important and this appears to be a good tool developed on a UK population.
4C Mortality Score tool – Click HERE
*Comorbidities inc: Chronic cardiac disease; chronic respiratory disease (excluding asthma); chronic renal disease (estimated glomerular filtration rate ≤30); mild-to-severe liver disease; dementia; chronic neurological conditions; connective tissue disease; diabetes mellitus (diet, tablet or insulin-controlled); HIV/AIDS; malignancy; clinician-defined obesity.
4C Mortality Score tool – Click HERE
Both COVID-19 infection and treatment with dexamethasone impair glycemic control. So its important to monitor blood sugars and consider DKA & HHS in COVID-19 patients. Latest guidance from DIABETES-UK
Trust Guidance varies slightly from BNF for those patients over 100kg
Dalteparin Cr Clearance >29ml/min | Dalteparin Cr Clearance 20-29ml/min | ||
---|---|---|---|
Weight (kg) | Dose | Weight (kg) | Dose |
<45kg | 7,500 units OD | <63kg | 5,000 units am 2,500 units pm |
45-56kg | 10,000 units OD | 63-80kg | 5,000 units BD |
57-68kg | 12,500 units OD | 81-98kg | 7,500 units am 5,000 units pm |
69-82kg | 15,000 units OD | 99-116kg | 7,500 units BD |
83-100kg | 18,000 units OD | 117-134kg | 10,000 units am 7,500 units pm |
101-115kg | 10,000 units BD | 135-152kg | 10,000 units BD |
116-140kg | 12,500 units BD | ||
>140kg | 15,000 units BD |
Weight (kg) | Dose |
---|---|
<50kg | 10,000 units OD |
50-69kg | 12,500 units OD |
70-79kg | 15,000 units OD |
80-89kg | 18,000 units OD |
90-109kg | 20,000 units OD |
110-124kg | 22,500 units OD |
125-139kg | 12,500 units BD |
140-154kg | 15,000 units am 12,500 units pm |
155-169kg | 15,000 units BD |
You may have seen in the news early results from the RECOVERY trial.
In Covid-19 patients requiring either Oxygen or Intubation, dexamethasone has been shown to reduce mortality.
Inclusion: Covid-19 patient requiring oxygen or intubation
Medication: (RECOVERY study protocol)
Post Dex Glucose monitoring: