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Paeds Casesinfectious-diseases

Paeds Cases · infectious-diseases

'It hurts at the line' — suspected central-line-associated bloodstream infection structured encounter

A bedside structured encounter testing recognition and surveillance definition of central-line-associated bloodstream infection, paired cultures and empiric therapy, the line-removal decision, antimicrobial de-escalation, communication and safe handover for a technology-dependent child.

structured clinical encounter5 min readVerification in progress

Target exams

RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
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Study tools

Target exams

RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
Aria is 6 and has a long-term central line for parenteral nutrition. She has had two days of fever and now rigors during a line flush; she points to the line saying it hurts.

Station status

This is one MedVellum formative structured clinical encounter. The scoring, prompts and performance descriptions are educational feedback tools. They are not an official college station, timing, mark allocation, pass score or reproduced examination format. The encounter assesses surveillance definition, recognition, paired cultures and empiric therapy, the line-removal decision, antimicrobial de-escalation, communication and safe handover. [3] [12]

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You have read the opening of this case. The complete unit — every section and its primary-source references — is part of the Paediatrics Fellowship fellowship library.

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References5ShowHide
  1. [1]Hsu HE, Mathew R, Wang R, et al. Health Care-Associated Infections Among Critically Ill Children in the US, 2013-2018. JAMA pediatrics, 2020.PMID 33017011
  2. [3]O'Grady NP, Alexander M, Burns LA, et al. Guidelines for the prevention of intravascular catheter-related infections. American journal of infection control, 2011.PMID 21511081
  3. [4]Miller MR, Griswold M, Harris JM 2nd, et al. Decreasing PICU catheter-associated bloodstream infections: NACHRI's quality transformation efforts. Pediatrics, 2010.PMID 20064860
  4. [9]McDonald LC, Gerding DN, Johnson S, et al. Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2018.PMID 29562266
  5. [12]Yokoe DS, Anderson DJ, Berenholtz SM, et al. A compendium of strategies to prevent healthcare-associated infections in acute care hospitals: 2014 updates. Infection control and hospital epidemiology, 2014.PMID 25026611
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Next'They're not themselves' — paediatric sepsis structured encounterinfectious-diseases