Скачать или смотреть Admission Protocol - Cellulitis - Summary

#Cellulitis #AdmissionProtocol #DrGregoryWeir #VascularSurgery #WoundCare #EdemaManagement #CompressionTherapy #PatientCare #HospitalProtocol #MedicalGuidelines #Nursing #ClinicalPractice #DVTProphylaxis #Antibiotics #PainManagement

This video summarizes Dr. Gregory Weir's admission protocol for cellulitis, designed for specialists, clinicians, and nurses.

Key steps include:
**Patient Identity & Welcome**: Confirm identity via multiple checks and create a welcoming atmosphere.
**Initial Investigations**: Standard blood tests (urea, creatinine, electrolytes, full blood count, C-reactive protein); other tests like chest x-ray or duplex Doppler are only done if specifically requested by the doctor.
**Medications**: Enoxaparin 40mg daily for DVT prophylaxis; initial pain relief with tramadol plus paracetamol (two tablets three times a day); antibiotic is ertapenem, one gram stat dose then one gram once daily for five to seven days. Oxycodone naloxone is an escalation option for pain.
**Critical Management**: Always elevate the affected limb; do not put a blood pressure cuff on or perform venipuncture on the affected limb.
**General Management**: Vital signs every six hours; document allergies and current medications; assess circulation (pulses, Doppler flow, color, temperature); ensure patient comfort and hygiene.
**Activity Levels**: Strict bed rest for the first 12 hours after admission, allowing only sitting at 45 degrees for eating/drinking. Afterward, once compression is on and arterial flow is adequate, frequent walking is encouraged, discouraging long periods of sitting or standing still. Smoking is actively discouraged.
**Compression**: Bandages are applied by the doctor only if arterial circulation is adequate, typically using the Africa bandage system. An orthotist assesses for Class 2 below-knee cotton compression hosiery once edema settles and there is no open wound. Anti-embolic stockings are never requested.
**Wound Care (if open wound)**: Clean skin around the wound and the wound center with Prontosan. Apply Inadine to the wound bed (check for iodine allergy; use ActiCote or another silver dressing if allergic). If exudate is present, apply a secondary absorptive dressing like Mizorb. Compression bandages (Africa system) should be used continuously until the wound is fully healed.
**Discharge Planning**: Ensure the patient receives compression hosiery before discharge. The doctor provides a discharge protocol document, a script for pentoxifylline, and ongoing pain medication if needed. A referral letter to a wound care specialist is provided for ongoing intensive wound care.

This comprehensive, step-by-step protocol aims to standardize care, minimize variations in practice, and improve outcomes for cellulitis, especially when vascular concerns are present.