Hospital-acquired pneumonia (HAP) in ICD10: Difference between revisions
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* If there is insufficient criteria for a [[Pneumonia, ventilator-associated (VAP)]] in ventilated patients with positive cultures, the patient may still have HAP. | * If there is insufficient criteria for a [[Pneumonia, ventilator-associated (VAP)]] in ventilated patients with positive cultures, the patient may still have HAP. | ||
* Patients from [[Grace Nursing Home Ward]] - even though this is considered a nursing home type ward, for patients who acquire a pneumonia and meet the HAP criteria '''code HAP'''. | * Patients from [[Grace Nursing Home Ward]] - even though this is considered a nursing home type ward, for patients who acquire a pneumonia and meet the HAP criteria '''code HAP'''. | ||
==RE:A pt with CAP on admission== | ==RE:A pt with CAP on admission== | ||
{{Discussion}} | {{Discussion}} | ||
If a patient with CAP on admission isn't ventilated for days then has to go on a ventilator then less than 48 hour ventilated develops a positive culture(quantitive bronchoscopically obtained) and a change in respiratory status can this be called HAP? Or are you saying it's CAP the whole admission? It seems according to the VAP quidelines patients with CAP can develop VAP under the right conditions so couldn't they also get HAP? Are you saying patients with CAP can never get HAP? | {{DiscussAllan | If a patient with CAP on admission isn't ventilated for days then has to go on a ventilator then less than 48 hour ventilated develops a positive culture(quantitive bronchoscopically obtained) and a change in respiratory status can this be called HAP? Or are you saying it's CAP the whole admission? It seems according to the VAP quidelines patients with CAP can develop VAP under the right conditions so couldn't they also get HAP? Are you saying patients with CAP can never get HAP? | ||
I will give an example cases: | I will give an example cases: | ||
*The pt has CAP no culture is sent. The patient is in the ICU for 8 days not on a ventilator. The ventilation status gets worse. The CXR continues to have persisent infiltrates. The pt gets intubated and less than 48 hours on a ventilator a bronchoscopy is done and both ETC and quantitive cultures grow aspergillos. Is this still CAP or can it be called HAP? | *The pt has CAP no culture is sent. The patient is in the ICU for 8 days not on a ventilator. The ventilation status gets worse. The CXR continues to have persisent infiltrates. The pt gets intubated and less than 48 hours on a ventilator a bronchoscopy is done and both ETC and quantitive cultures grow aspergillos. Is this still CAP or can it be called HAP? | ||
*Same scenerio as above occurs but a patient isn't treated for what ever bug grows in the cultures. Do we code the bug or not. Do we call it colonization or ignore the culture? | *Same scenerio as above occurs but a patient isn't treated for what ever bug grows in the cultures. Do we code the bug or not. Do we call it colonization or ignore the culture?}} | ||
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