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aIGIM should be administered deep into a large muscle mass. Ordinarily, no more than 5 mL should be administered in one site in an adult or large child; lesser amounts (maximum 3 mL in one site) should be administered to small children and infants.bIGIM is in short supply. When IGIM is unavailable, use of hepatitis A vaccination is preferable to intervention at all. Please call the SHD Communicable Disease Program at 425.339.5278 if you would like consultation in such a situation. cDosage and schedule of hepatitis A vaccine as recommended according to age. Only monovalent hepatitis A vaccine (Havrix or Vaqta) should be used for postexposure prophylaxis. If monovalent hepatitis A vaccine is not available, however, then another preparation is an acceptable alternative to no vaccination at all.
To avoid missed opportunities, emergency departments, healthcare systems and clinics should routinely offer HAV vaccine at all clinical encounters to persons at increased risk, including those living homeless and persons who inject drugs, and healthcare providers should counsel patients regarding risk for HAV infection. In addition, HAV vaccine should be offered to anyone who wishes to reduce their risk of infection (See CDC hepatitis A vaccine recommendations, below).
Cases of unexplained vaping-associated pulmonary illnesses are being investigated by public health officials in multiple other states. Patients presented with respiratory symptoms including cough, shortness of breath, and fatigue. Symptoms worsened over a period of days or weeks before admission to the hospital. Other symptoms reported by some patients included fever, chest pain, weight loss, nausea, and diarrhea. Chest radiographs showed bilateral opacities, and CT imaging of the chest demonstrated diffuse ground-glass opacities, often with sub-pleural sparing. Evaluation for infectious etiologies was negative among nearly all patients.
Some patients experienced progressive respiratory compromise requiring mechanical ventilation but subsequently improved with corticosteroids. All patients reported “vaping” (i.e., use of e-cigarette devices to aerosolize substances for inhalation) in the weeks and months prior to hospital admission. Many have acknowledged recent use of tetrahydrocannabinol (THC)-containing products while speaking to healthcare personnel or in follow-up interviews by health department staff; however, no specific product has been identified by all cases, nor has any product been conclusively linked to this clinical syndrome.
The CDC is urging health care providers to report any cases of significant respiratory illness of unclear etiology and a history of vaping to their local health jurisdiction. The Washington State Department of Health has requested that local health jurisdictions report if there are any cases in the area they serve.
The University of Washington, School of Nursing, is offering 1-day FREE workshops for nurses, midwives, and other providers in a hospital setting who provide care for women and newborns affected by Opioid Use Disorder (OUD), using Promoting First Relationships in Pediatrics training.
Registration link for Seattle workshop on September 10:https://www.pcrprograms.org/training/promoting-first-relationships-in-pediatrics-seattle/
In this workshop you will to learn how to better nurture and support the parent-child relationship during daily patient encounters. The program combines the new science of early brain development with established attachment-based practices to give medical providers the knowledge, skills and confidence to support women and newborns affected by OUD.