Dialysis Event
Page 1 of 4 *required for saving Facility ID:
Risk Factors
*Vascular accesses: (check all that apply)
Other Patient Information Event Details
*Specify Dialysis Event: (check at least one)
IV antimicrobial start
Was vancomycin the antimicrobial used for this start?
Positive blood culture (*specify pathogen and antimicrobial susceptibilities on pages 2-3)
*Suspected source of positive blood culture (check one):
A source other than the vascular access
Pus, redness, or increased swelling at vascular access site
*Check the access site(s) with pus, redness, or increased swelling:
*Specify Problem(s): (check one or more)
Wound (NOT related to vascular access) with pus or increased redness Cellulitis (skin redness, heat, or pain without open wound) Pneumonia or respiratory infection Other problem (specify): __________________________________________________________ None
Assurance of Confidentiality: The voluntarily provided information obtained in this surveillance system that would permit identification of any individual or institution is collected with a guarantee that it will be held in strict confidence, will be used only for the purposes stated, and will not otherwise be disclosed or released without the consent of the individual, or the institution in accordance with Sections 304, 306 and 308(d) of the Public Health Service Act (42 USC 242b, 242k, and 242m(d)). Public reporting burden of this collection of information is estimated to average 16 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC, Reports Clearance Officer, 1600 Clifton Rd., MS D-74, Atlanta, GA 30333, ATTN: PRA (0920-0666). CDC 57.109 (Front) Rev 5, v6.6
Dialysis Event Gram-positive Organisms CIPRO/LEVO/MOXI DOXY/MINO GENTHL§ STREPHL§ CIPRO/LEVO/MOXI DOXY/MINO GENTHL§ STREPHL§ Staphylococcus CHLOR CIPRO/LEVO/MOXI DOXY/MINO OX/CEFOX/METH Gram-negative Organisms CIPRO/LEVO MERO/DORI PIP/PIPTAZ TETRA/DOXY/MINO Escherichia coli AMK AMPSUL/AMXCLV CEFOT/CEFTRX CEFOX/CETET CIPRO/LEVO/MOXI MERO/DORI TETRA/DOXY/MINO AMPSUL/AMXCLV CEFOT/CEFTRX CEFOX/CETET CIPRO/LEVO/MOXI MERO/DORI TETRA/DOXY/MINO AMPSUL/AMXCLV CEFOT/CEFTRX CEFOX/CETET CIPRO/LEVO/MOXI MERO/DORI TETRA/DOXY/MINO Dialysis Event Gram-negative Organisms (continued) AMPSUL/AMXCLV CEFOT/CEFTRX CEFOX/CETET CIPRO/LEVO/MOXI MERO/DORI TETRA/DOXY/MINO CIPRO/LEVO MERO/DORI PIP/PIPTAZ TETRA/MINO Fungal Organisms Other Organisms Result Codes S = Susceptible I = Intermediate R = Resistant NS = Non-susceptible S-DD = Susceptible-dose dependent N = Not tested § GENTHL and STREPHL results: S = Susceptible/Synergistic and R = Resistant/Not Synergistic Drug Codes: STREPHL = streptomycin –
TETRA = tetracycline TICLAV = ticarcillin/clavulanic
Dialysis Event
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BIOGRAPHICAL DATA [November 2006] Name: John E. Damilakis Education: University of Crete, Medical School, Iraklion, Crete University of Surrey, Guildford, England Current Position: Assistant Professor of Medical Physics, Dept of Medical Physics, University of Crete, Faculty of Medicine, Iraklion, Crete, GREECE Career-related activities: 1998-2000, President of the ‘Greek
Sore Hocks: To inject or not to inject? by Michael Scott, DVM; MVSc; Diplomate, American College of Veterinary Surgeons Dr. Michael Scott is an equine surgical specialist practicing at Moore and Company Veterinary Services in Calgary, Alberta. He has been a lifelong rider, competitor, and horse enthusiast. His practice interests include equine sports medicine, lameness diagnosis
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