CCS:Infected peripheral IV access - USMLE Forums
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Old 09-22-2011
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Default CCS:Infected peripheral IV access

iva (if central line, dc cental line and new central line)
vitals q1h (qday when stable temp)
cardiac monitor (risk of septic shock)
fingerstick stat
cbc stat
bmp stat

focused pe

pt/ptt stat
blood cx
xray site
doppler arm
remove iv line
cath tip for c+s, gm stain, fungal cx
clinda + zosyn (if admitted >48 hrs)
2 d echo

full pe
elevate arm
bed rest
iv nss
iv heparin if signs of cord-like thickening/bluish discoloration
(new iv access already done in beginning to give empiric abx)

when cx back:
iv naf for 2-3 days (until improvement)
dc zosyn and clinda
in this case do not worry abt dc'ing patient or po meds and patient has iv line for a reason.

5 min:
repeat cbc, chem in 3-4 days

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