Cardiovascular | Right Decisions

Right Decisions
Antimicrobial prescribing: NHS Fife
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Paediatric Hospital Antimicrobial Guideline
Cardiovascular

Please update your RDS mobile app to version 4.7.1

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. When you install the update, you will see that each toolkit has a small QR code icon 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 install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency 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.

Bacterial Endocarditis

Consult a Cardiologist immediately and liaise with the on-call Microbiologist. Ensure 3 sets of blood cultures are obtained PRIOR to initiation of antibiotic therapy and that adequate volumes are obtained.

If the disease is slowly progressing and the patient is stable, consider delaying antimicrobial therapy pending blood culture results.

For children with structural heart defects who are at risk of endocarditis who present with fever should have 2 sets of blood cultures prior to antimicrobial therapy irrespective of focus of infection.

Central Line Infection

It is important to obtain blood cultures through both the vascular catheter and peripheral venepuncture.

Intravascular catheter-related sepsis

Teicoplanin IV

Plus

Gentamicin IV

Duration: 10 days from line removal

Teicoplanin is preferred to vancomycin because these patients frequently have single lumen vascular catheters and are often on TPN.

Discuss with the specialty service responsible for the line

Non-tunnelled central venous catheters and arterial cannulae

Vancomycin IV

Duration: 10 days from line removal

Discuss with Microbiology