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)
oxy
vitals q1h (qday when stable temp)
cardiac monitor (risk of septic shock)
fingerstick stat
b-hcg
cbc stat
bmp stat

focused pe

pt/ptt stat
ua/uc+s
blood cx
cxr
esr
crp
xray site
doppler arm
remove iv line
cath tip for c+s, gm stain, fungal cx
clinda + zosyn (if admitted >48 hrs)
tylenol
ekg
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
counsel
screen

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