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Please note that clinical judgement
supersedes all guidelines
Cancer, new diagnosis
Expedited partner treatment
Search "STI Discharge with Partner Treatment" under disposition smart sets
Tips:
- You do not need the partner's name or information
- These rx's must be sent to discharge pharmacy or OMC
- For adolescents, click "hide from proxy" on the rx
Sepsis
Use the Quick List for orders:
Tips:
- Sepsis Alert Guide
- Sepsis = SIRS criteria + suspected bacterial source
- T > 38 or < 36
- HR > 90
- RR > 20 or PaCO2 < 32
- WBC > 12k or <4k or > 10% bands
- Can document high suspicion for viral etiology if deferring sepsis work-up
- 30 cc/kg IVF bolus is required for hypotension or lactate >=4
- Document .fluidharmsepsis if not administering full 30 cc/kg in this scenario
- Reassess perfusion if still hypotension/lactate >4 AFTER fluids
(cap refill, skin color/warmth, peripheral pulses)
- Antibiotics must be given within 3h of sepsis recognition
Syphilis: eye involvement
Consult ID and Ophtho if:
- Evidence of syphilis infection, AND
- Visual changes
(CSF may be normal)
Syphilis: NEURO involvement
Consult ID if:
- Evidence of syphilis infection AND
- Clinical concern for neurosyphilis AND
- CSF WBC or protein are abnormal (send VRDL but has low sensitivity and does not come back quickly).
STI Screening
In asymptomatic patients who require tests for a program or placement, can consider directing to the STD clinic.
Call the Denver Sexual Health Clinic - (303) 602-3540. With that phone call, patients can be scheduled for a testing appt same day or next day (M-F).
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