Addenbrook Hospital Antibiotic guide line

Addenbrook's antibiotic guide line

DKA Guide line

DKA guide line

Methotrexate guidelines

Methotrexate guide lines

Insertion of a central venous catheter

About insertion of a central venous catheter

A central venous catheter, or central line, is a long hollow tube made of silicon rubber which is placed into one of the large veins in the body. One end of the line remains outside the body and can be used for injections. The other end is positioned inside a large vein, usually near to the heart. There are a number of veins into which the catheter can be placed; the most common being the axillary vein that lies just beneath the clavicle (collar bone) or the jugular vein that lies just above the clavicle at the base of the neck.

Insertion of a PICC

A peripherally inserted central catheter (PICC) is a long hollow tube that is inserted into one of the large veins your arm. One end of the tube sits in a vein (usually just above the heart) and the other end comes out from underneath the skin in your arm. The catheters are usually recommended for patients who need certain types of medicines or treatments that are irritant or damaging to smaller veins; or whom need injections over a long period of time. Insertion of the catheter requires a sterile operation, which is usually performed under local anaesthetic. More information on PICC’s is given in the further information section below.

Mental capacity and consent to treatment guidance for clinicians

1.1 Treatment without valid consent is potentially an assault. In most cases gaining valid consent is straight forward, as most patients are clearly able to understand the information presented.

 

1.2 Where this is not the case, there is a problem because nobody else, not even the next of kin, can give consent on behalf of an adult who lacks capacity (this is different for children).

 

1.3 It is important that all doctors have a clear understanding of the relevant issues relating to Capacity to Consent to treatment and how to assess the patient’s capacity to make decisions, especially in respect of consent to treatment. If you have any concerns about your ability to adequately assess capacity to consent you must involve a senior colleague

Antibiotics guide line

short antibiotic guide line

Geriatric: ordering investigations

Geriatric: Ordering Investigation

 1. General referrals

  • U&E
  • Full blood count
  • Bone

Antibiotic Guide lines in QEH

DOSING AND MONITORING OF GENTAMICIN Monitoring is recommended for all patients in whom it is anticipated that aminoglycosides will be given for more than 2 days. The principal objective is to delay the onset of nephrotoxicity and reduce the risk of ototoxicity.

Clinical features compatible with PE

Clinical features compatible with PE include

Breathlessness *
Tachypnoea (RR>20)
Pleuritic Chest Pain
Haemoptysis

Clinical risk score

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