In this section
Peritonitis is suspected if the patient has ANY of the following Signs or Symptoms:
SAVE FIRST CLOUDY BAG
Parents are instructed to bring the cloudy bag in with them to ED
* WCC >50% polymorphs if cell count available
On consultation with nephrologist: UNLESS THE CHILD’S CLINICAL PRESENTATION REQUIRES URGENT ACTION ensure the effluent has been dwelling for 2 hours before collecting sample.
An empiric diagnosis of peritonitis should be made if:
Empiric maintenance dosing:
Antifungal cover is compulsory to prevent fungal peritonitis
Antifungal prophylaxis is used whilst undergoing antibiotic treatment: Nilstat 1-2mls orally QID
Check vancomycin level at 48 hours
Culture results at 48 hours to determine targeted treatment
Consider ceasing IP antibiotics in consultation with Consultant Nephrologist and depending on initial presentation
Modify IP antibiotic cover depending on sensitivities, in consultation with Consultant Nephrologist.
A contamination is any breach of the Tenckhoff or PD set-up at any time.
An Extension change is required and must be attended to by the PD coordinator or an accredited PD nurse
See protocol: 3.5 Extension Catheter Change