Hospital Acquired Pneumonia | Right Decisions

Update your RDS mobile app to v4.7.2 to download toolkits even when website is down.

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. You will see that each toolkit has a small QR code icon in the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively update to the latest release - RDS app version 4.7.1 - to see this improvement.

Updating to this latest version of the RDS app is also strongly recommended to get the full benefits of the new resilience arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits. To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

Duration

5 days and review

Early Onset - within 48 hours of hospital admission

Important: Therapy

Treat as Community Acquired Pneumonia

Notes:

Late Onset - more than 48 hours from hospital admission

Important: Therapy

Low Severity

Doxycycline 200mg oral on first day then 100mg daily

OR

Co-trimoxazole 960mg oral 12 hourly

High Severity

Amoxicillin 1g IV 8 hourly

+

Gentamicin IV (Extended Interval Dosing as per guideline. Use gentamicin calculator). Max 3 days then review.

Penicillin allergy OR previous MRSA

Vancomycin (dosing as per guideline. Use vancomycin calculator)

+

Gentamicin IV (Extended Interval Dosing as per guideline. Use gentamicin calculator). Max 3 days then review.

Notes:

IV to Oral Switch

Important: Therapy

Doxycycline 200mg oral on first day then 100mg daily

OR

Co-trimoxazole 960mg oral 12 hourly

Notes:

Important: Notes

Diagnosis

New lung infiltrates on chest X-ray PLUS evidence of infection

Severity Assessment

Treat as high severity if two or more of:

Low blood pressure (SBP≤100 mmHg)
High respiratory rate (≥22 breaths per min)
Altered mentation (Glasgow Coma Scale <15)

Required Investigations

Chest X-ray PLUS in high severity disease:

Blood culture
Sputum culture

Viral throat swab (swab throat and nose at same time with single swab, send in viral transport medium)

Notes

Reassess daily and discuss with Microbiology if failing to respond after 48-72 hours.

Likely organisms; S. pneumonia (50% HAP), S.aureus, Coliforms, viruses, occasionally Pseudomonas spp.

If patient has been given a course of doxycycline in the past 30 days, consider alternative treatments.