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Nosocomial Infection - Coggle Diagram
Nosocomial Infection
Risk factors
Skin integrity
Urethral catheterisation
Gut injury
bacterial translocation
ILeus
NG tube insertion
PPI
Malnutrition
Foreign material
Broad spectrum antibtiocs
alterations incommensal flora
Definition
Infection diagnosed >48-72 hours after admission to hospital
EPIC 1 in 5 ICU patients acquire infection
EPIC II
3/5 respiratory
1/5 abdominal
Bactereamia
UTI
Types
CRBSI
Coagulase neg staph
S. Aureus
Gram neg
entercocci
E.Coli
Klebsiella
Fungal
Candida
VAP
Early <4days
Strep pnumonoiae
Haemophylus influenzae
MSSA
Antibiotics sensitive gram neg
E.Coli
Klebsiella
Enterobacter
Late > 4 days
MRSA
Acintobacter
Psudomonas
ESBL
Scoring system
CPIS
Score 0-2
6 categories
Out of 12, >6 shows good correlation with the presence of VAP
Management
Conservative
Catheter bundle
Hand hygiene
Asepsis
Skin prep 2% chlorhexidine 70% alcohol
Aviod femoral route
Daily review
VAP
Lung protective ventilation
VAP bundle
Head up 30 degrees
oral decontamination (with chlohexidine)
Daily sedation holds
Thromboprophylaxis
Gastric ulcer prophylaxis
Other
Subglottic suction
Silver coated ETT
Cuff pressures >20
Prophylactic antibtiotics
Minimise re-intubation
Selective deconamination of the bowel
Enteral PTA
Polymixin E
Tobramycin
Amphotericin B
Parenteral
Anti-spsudomonal eg cephalosporin