Guide to YKHC Medical Practices - Recent changes [en]

Amoxicillin Allergy Trials

LiamG — Tue, 12 May 2026 20:04:31 GMT

← Older revision		Revision as of 20:04, 12 May 2026
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	~~H/O amoxicillin~~ allergy is rarely a true allergy. Get more information about what the reaction was, at what age it occurred, look at telemed pictures if you can, consult a pediatrician if they are little and consider amoxicillin challenge in the village OR bring them to ~~ER or~~ clinic in Bethel for this. Over 90% of the time there was not a true allergy ~~and~~ the flag was put on EMR because a parent reported a ~~h/o~~ rash or hives that was not really hives OR it was imported from our old medical record system and was not validated.		Amoxicillin allergy is rarely a true allergy. Get more information about what the reaction was, at what age it occurred, look at telemed pictures if you can, consult a pediatrician if they are little, and consider amoxicillin challenge in the village OR bring them to clinic in Bethel for this. Over 90% of the time, there was not a true allergy; often, the flag was put on EMR because a parent reported a history of rash or hives that was not really hives OR it was imported from our old medical record system and was not validated.

	~~==Example Auto text for RMT For Amoxicillin Trial==~~		Autotext: ..rmtamox
	~~'''~~Autotext:~~'''~~ ..rmtamox

	~~'''ASSESSMENT:'''~~
	*Patient’s history and medical records were reviewed and the patient does not have any evidence of a true allergy to amoxicillin.
	*CHA and family are OK with trial of Amoxicillin

	~~'''PLAN: '''~~
	*Recommend Amoxicillin trial in clinic today.
	*Document vitals, physical exam and good lung exam
	*Have epinephrine available.
	*Mix Amoxicillin
	*Draw up a CHAM, weight based dose of Amoxicillin.
	*Give the patient 1/10th of the dose in the clinic.
	*Have patient remain at the clinic for 20 minutes for observation. Caretaker is to alert the CHAs of any concerns.
	*After 20 minutes, if there are no problems, the patient may be given the rest of the dose of Amoxicillin.
	*Have patient remain at the clinic for another hour for observation in waiting room..
	*If there are no problems tolerating the test doses, then the patient may go home and continue medicine as prescribed.
	*If a rash or any concerns come up, the patient should be brought back to clinic and a telemed picture and RMT should be sent in for the provider to review and get a pediatric consult if required.
	*Give Amoxicillin Rash Handout to family to take home. Rash with amoxicillin is common in infants and young children and it is usually OK to continue the medicine unless the patient develops true hives, face swelling or difficulty breathing.

	==Resources/References==		==Resources/References==
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	* Khan, D. et al. [https://www.sciencedirect.com/science/article/pii/S0091674909015644?via%3Dihub Drug allergy.] J Allergy Clin Immunol 2010;125:S126-37.		* Khan, D. et al. [https://www.sciencedirect.com/science/article/pii/S0091674909015644?via%3Dihub Drug allergy.] J Allergy Clin Immunol 2010;125:S126-37.
	* Solensky, R. et al. [https://www.aaaai.org/Aaaai/media/MediaLibrary/PDF%20Documents/Practice%20and%20Parameters/drug-allergy-updated-practice-param.pdf Drug Allergy: An Updated Practice Parameter.] Ann Allergy Asthma Immunol. 2010 Oct;105(4):259-273. doi: 10.1016/j.anai.2010.08.002		* Solensky, R. et al. [https://www.aaaai.org/Aaaai/media/MediaLibrary/PDF%20Documents/Practice%20and%20Parameters/drug-allergy-updated-practice-param.pdf Drug Allergy: An Updated Practice Parameter.] Ann Allergy Asthma Immunol. 2010 Oct;105(4):259-273. doi: 10.1016/j.anai.2010.08.002
	* [[~~media~~:Stamping Out Amoxicillin Allergies - 8-6-2019.pdf\|Stamping Out Amoxicillin Allergies 2019]] (PowerPoint Presentation)		* [[Media:Stamping Out Amoxicillin Allergies - 8-6-2019.pdf\|Stamping Out Amoxicillin Allergies 2019]] (PowerPoint Presentation)
	* [[Media:Stamping Out Amoxicillin Allergy.pdf\|Stamping Out Amoxicillin Allergy 2013]] (PowerPoint Presentation)		* [[Media:Stamping Out Amoxicillin Allergy.pdf\|Stamping Out Amoxicillin Allergy 2013]] (PowerPoint Presentation)
	* [[~~media~~:~~Amoxicillin_allergy_trials~~.pdf\|Amoxicillin Allergy Trials YKHC Clinical Guideline]]		* [[Media:Amoxicillin allergy trials.pdf\|Amoxicillin Allergy Trials YKHC Clinical Guideline]]


	[[:category:YKHC Guidelines\|YKHC Clinical Guidelines]]		[[:category:YKHC Guidelines\|YKHC Clinical Guidelines]]
	<br/>[[Practicing Medicine in Bush Alaska—Some ABCs\|Common/Unique Medical Diagnoses]]		<br/>[[Practicing Medicine in Bush Alaska—Some ABCs\|Common/Unique Medical Diagnoses]]

Physical Therapy

LiamG — Tue, 12 May 2026 19:42:00 GMT

← Older revision		Revision as of 19:42, 12 May 2026
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	* ordering [[DME equipment]]: walkers and wheelchairs		* ordering [[DME equipment]]: walkers and wheelchairs
	* stroke and other neuro rehabilitation		* stroke and other neuro rehabilitation
	* ([[Media:~~pelvicfloorthearpy~~.pdf\|pelvic floor physical therapy]])		* [[Media:Pelvicfloorthearpy.pdf\|pelvic floor physical therapy]]
	*''knee injections are not done by PT, but by providers in clinic''		*''knee injections are not done by PT, but by providers in clinic''
	They also travel to all of the subregional clinics several times a year to treat patients in these areas.		They also travel to all of the subregional clinics several times a year to treat patients in these areas.

File:Pelvicfloorthearpy.pdf

LiamG — Tue, 12 May 2026 19:40:28 GMT

LiamG uploaded File:Pelvicfloorthearpy.pdf

New page

Physical Therapy

LiamG — Tue, 12 May 2026 19:39:35 GMT

← Older revision		Revision as of 19:39, 12 May 2026
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	* ordering [[DME equipment]]: walkers and wheelchairs		* ordering [[DME equipment]]: walkers and wheelchairs
	* stroke and other neuro rehabilitation		* stroke and other neuro rehabilitation
			* ([[Media:pelvicfloorthearpy.pdf\|pelvic floor physical therapy]])
	*''knee injections are not done by PT, but by providers in clinic''		*''knee injections are not done by PT, but by providers in clinic''
	They also travel to all of the subregional clinics several times a year to treat patients in these areas.		They also travel to all of the subregional clinics several times a year to treat patients in these areas.

Category:YKHC Guidelines

LiamG — Tue, 12 May 2026 19:37:32 GMT

Preventative Health Care & Outpatient Protocols

← Older revision		Revision as of 19:37, 12 May 2026
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	==Preventative Health Care & Outpatient Protocols==		==Preventative Health Care & Outpatient Protocols==
	* [[Media:Amoxicillin allergy trials.pdf\|Amoxicillin Allergy Trials (Pediatric)]]; [[Amoxicillin Allergy Trials\|supplement]]		* [[Media:Amoxicillin allergy trials.pdf\|Amoxicillin Allergy Trials (Pediatric)]]; [[Amoxicillin Allergy Trials\|supplement]]
	* [[Media:Aspirin.pdf\|Aspirin for Adults >40 without Known Cardiovascular Disease]]; [[Aspirin\|supplement]]
	* [[Media:Breast cancer screening.pdf\|Breast Cancer Screening]]; [[Breast Cancer Screening\|supplement]]		* [[Media:Breast cancer screening.pdf\|Breast Cancer Screening]]; [[Breast Cancer Screening\|supplement]]
	* [[Media:Cervical Cancer Screening.pdf\|Cervical Cancer Screening with hrHPV]]; [[Cervical Cancer Screening\|supplement]]		* [[Media:Cervical Cancer Screening.pdf\|Cervical Cancer Screening with hrHPV]]; [[Cervical Cancer Screening\|supplement]]

File:Antibiogram.pdf

LiamG — Wed, 06 May 2026 12:41:15 GMT

LiamG uploaded a new version of File:Antibiogram.pdf

New page

HROB Stickers--Problems/Plans

LiamG — Tue, 21 Apr 2026 01:08:02 GMT

Show changes

← Older revision		Revision as of 19:37, 12 May 2026
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	==Preventative Health Care & Outpatient Protocols==		==Preventative Health Care & Outpatient Protocols==
	* [[Media:Amoxicillin allergy trials.pdf\|Amoxicillin Allergy Trials (Pediatric)]]; [[Amoxicillin Allergy Trials\|supplement]]		* [[Media:Amoxicillin allergy trials.pdf\|Amoxicillin Allergy Trials (Pediatric)]]; [[Amoxicillin Allergy Trials\|supplement]]
	* [[Media:Aspirin.pdf\|Aspirin for Adults >40 without Known Cardiovascular Disease]]; [[Aspirin\|supplement]]
	* [[Media:Breast cancer screening.pdf\|Breast Cancer Screening]]; [[Breast Cancer Screening\|supplement]]		* [[Media:Breast cancer screening.pdf\|Breast Cancer Screening]]; [[Breast Cancer Screening\|supplement]]
	* [[Media:Cervical Cancer Screening.pdf\|Cervical Cancer Screening with hrHPV]]; [[Cervical Cancer Screening\|supplement]]		* [[Media:Cervical Cancer Screening.pdf\|Cervical Cancer Screening with hrHPV]]; [[Cervical Cancer Screening\|supplement]]