This table cannot be relied upon in the absence of: PA Medical Directive #3 - Ophthalmology

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Oswin Adrian Russell
5 years ago
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1 Title and Number f Directive: Order Table PA-3: Ophthalmlgy This table cannt be relied upn in the absence f: PA Medical Directive #3 - Ophthalmlgy 1. OVERALL CONDITIONS - The PA may evaluate and prvide care fr patients presenting with the fllwing new r nging cnditins: Disrders f glbe Freign bdy in eye Crneal abrasin Cataract Red eye Subcnjunctival hemrrhage Disrders f adnexa Dacrcystitis Blepharitis Hrdelum Chalazin Entrpin & Ectrpin Perirbital swelling Allergic reactin Prerbital cellulitis Disrders f cnjunctiva Viral cnjunctivitis Bacterial cnjunctivitis Pinguecula Pterygium Visual pathways Strabismus Amblypia Ocular symptms Blurred visins Decreased visual acuity Ocular r perirbital discmfrt 1

2 - Directives fr Peridic Health Exam apply, with adaptatins as identified in this rder table. - PA will discuss patient status and care with the physician n an nging basis as identified in the Practice Outline, and as necessary. Guidelines: - Anti-infective Guidelines fr Cmmunity-acquired Infectins, 2012 editin. - Cmpendium f Pharmaceuticals and Specialties, Orders Indicatins and Cntraindicatins. 2. HISTORY AND PHYSICAL EXAMINATION - The PA may cmplete a fcused histry based n presenting cnditin. Histry f present illness. Pertinent past medical histry. - Fcused physical exam may include: Vital signs. Eye exam, which may include fundscpy, visual acuity and slit lamp examinatin. 3. COUNSELING - Envirnmental factrs if cntributry. - Supprtive therapy as apprpriate, e.g. warm cmpresses. 2

3 4. LABS AND INVESTIGATIONS - Flurscein staining. Indicatins: - Suspected freign bdy r crneal abrasin. - Ocular anesthesia Indicatins: - Prir t perfrming cular exam fr freign bdy r crneal abrasin. Cntraindicatins: - Nt t be prescribed fr hme use. - Swab fr C&S. Indicatins: - Suspected infectius agent. - X-ray. Indicatins: - Suspected radipaque freign bdy. - CT scan in cnsultatin with supervising physician. Indicatins: - Suspected rbital cellulitis. 5. IMMUNIZATIONS - In accrdance with PA Medical Directive #1 Peridic Health Exam. Guidelines: - Canadian Immunizatin Guide Seventh Editin

4 6. THERAPEUTICS Tpical antibitics: - The PA may prescribe the fllwing tpical antibitics: Azithrmycin. Bacitracin, including cmbinatin agents cntaining bacitracin. Ciprflxacin. Erythrmycin. Gentamicin. Levflxacin. Mxiflxacin. Nemycin, plymyxin B and gramicidin. Oflxacin. Sulfacetamide. Tbramycin. Trimethprim and plymyxin B. Indicatins: - Bacterial cnjunctivitis. Cntraindicatins: - Sft cntact lenses shuld nt be wrn when using agents that cntain benzalknium chlride r during treatment f phthalmlgic infectins. - Cnsult supervising physician if: Suspected herpes simplex cular infectin. Tpical vascnstrictrs: - The PA may prescribe the fllwing vascnstrictrs: Naphazline. Tetrahydrzline. Indicatins: - Allergic cnjunctivitis. - Decrease in eye redness. Cntraindicatins: - Sft cntact lenses shuld nt be wrn when using agents that cntain benzalknium chlride. 4

5 Tpical antihistamines: - The PA may prescribe the fllwing antihistamines: Azelastine. Kettifen. Levcabastine. Indicatins: - Allergic cnjunctivitis. Cntraindicatins: - Sft cntact lenses shuld nt be wrn when using agents that cntain benzalknium chlride. 7. PROCEDURES - The PA may remve cular freign bdy with irrigatin r cttn-tipped applicatr. Indicatins: - Ocular freign bdy. 8. REFERRALS - Ophthalmlgists in cnsultatin with supervising physician. Indicatins: - Patients requiring cnsultatin with specialist. - Optmetrists. Indicatins: - Annual visits fr all patients with diabetes r hypertensin. 9. ABSENTEE NOTES The PA may write absentee ntes as apprpriate. 5

This table cannot be relied upon in the absence of: PA Medical Directive #4 Otolaryngology

This table cannot be relied upon in the absence of: PA Medical Directive #4 Otolaryngology Title and Number f Directive: Order Table PA-4: Otlarynglgy This table cannt be relied upn in the absence f: PA Medical Directive #4 Otlarynglgy 1. OVERALL CONDITIONS - The PA may evaluate and prvide care