Step III Giardiasis Ccs?

[DOC2KGILL]

hi this is regarding a ccs case-if a pt comes in office with diarrhea with mucous,no blood,bloating ,long duration,camping history,no signific distress,so do we order the tests n start metronidazole n send him home,or do we order tests,send him home with oral rehydration n wait for test results to come and then call him back to prescribe med?????????please help!!!!!!!!!!!!🙁

 

[Critical Mass]

hi this is regarding a ccs case-if a pt comes in office with diarrhea with mucous,no blood,bloating ,long duration,camping history,no signific distress,so do we order the tests n start metronidazole n send him home,or do we order tests,send him home with oral rehydration n wait for test results to come and then call him back to prescribe med?????????please help!!!!!!!!!!!!🙁

Don't wait for the O&P to come back, especially if it had to go out to a reference lab. No telling how long it will take them to look at it.

 

[jakesaw]

For the CCS (vs real life):

After the PE order stool culture/stool for ova and parasites. Give something like BSS for diarrhea and advise hydration. Hit "next available result". When it comes back for giardiasis then treat with metro.

(The CCS CD explains "....treating with metronidazole AFTER confirming the diagnosis of giardiases).

P.S.--don't forget to advise "no alcohol" when treating with metro. Good luck.

 

[leydig]

what is BSS? Could you get the O&P result back on the same day? If not, do you send the pt home first?

 

[JayneCobb]

Could you get the O&P result back on the same day? If not, do you send the pt home first?

You could possibly get limited O&P results back, but I've never seen final results for at least 2 days. if you truly suspect giardia and they are clinically stable enough to go home and maintain hydration, go ahead and start the Metro before the results.

 

[jakesaw]

what is BSS?

bismuth salicylate (pepto bismol).