Protocols - Hemorio

TREATMENTO AND IN
ADULTS AT ANY AGE
REINFORCEMENT ON
EVERY FALL
- Hepatitis B (HbsAg, anti-Hbc and anti-Hbs (-) with a timeout < 3 m)
- Pneumo 23 in non-vaccinated patients and/or that who will be submitted to splenectomy
with 5-year reinforcement .
- Anti-Haemophyllus influenza in non-vaccinated.
- Influenza (flu) – annually in the fall
- Anti-tetanus every 10 years, specially in patients with leg ulcers
- Influenza vaccine
INFECTION: In children less than 5 years old, the major cause of death from septicemia and meningitis is
due to Streptococos pneumoniae and Haemophyllus influenza infection. Infections may precipitate vasoocclusive
crisis and anemia exacerbations, by erythropoietic suppression or hemolysis .
ANTIBIOTICS PROFILAXY:
ORAL PENICILLIN V (PEN-VE-ORAL)
- Initiated at the moment of the diagnostic
- Maintained until 5 years, up to reinforcement of pneumococcal vaccine
- Prophylaxis must be taken in consideration according to each case on elderly patients
- Up to 10kg or 1 year = 1.5ml V.O. 12/12h
- to 1year from 3 years = 2.5ml V.O. 12/12h
- >3 years = 5ml V.O. 2x day
- PENICILLIN BENZATHINE
- In case of gastric intolerance, noncompliance with the treatment with oral penicillin or impossibility of oral
penicillin (approximately 50.000 U/Kg)
- 300,000 IU – patients weighting < 10 Kg, IM every 3 weeks
- 600,000 IU – patients from 10 to 20 Kg, IM every 3 weeks
- 1,200,000 IU – patients weighting > 20 Kg, IM every 3 weeks
- ERYTHROMYCINE
- In case of penicillin allergy
- Dose: 20 mg / kg / day divided twice a day
CONDUCTION IN THE INFECTIOUS PICTURE
- Thoracic RX
- Complete blood test + VHS + Ret + Ptn C-Reactive
- Biochemistry (TGO, TGP, LDH, bilirubins, urea, creatinine)
- SAE + Urine culture + Blood culture
- Pulse oximeter
- 12-hour observation
HOSPITALIZATION INDICATIONS (AT LEAST 1 FROM BELOW):
- Major decrease of general state
- Hypotension
- Dehydrated or peripheral malperfusion
- Oximetry Evaluation (STA) < 80% of saturation or experienced drop > 5% from baseline value
- Pulmonary infiltrate
- Leukocyte > 30000 or < 5000 / mm 3
- Platelet Count < 100000 / mm 3
- History or similar scene with S. pneumoniae infection
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