Hospital Acquired Pneumonia Management

Consider the following, not everything will be appropriate for every patient:

1. Chest x-ray

2. Routine blood tests including inflammatory markers – CRP, Procalcitonin, White cell count

3. ABG - an arterial blood gas gives oxygen and carbon dioxide levels, as well as lactate and acid/ base balance.

3. Antibiotics – refer to local antimicrobial guidelines

4. Supplemental oxygen to maintain target saturation range:

  • Consider humidified oxygen to aide secretion clearance

5. Microbiology: 

  • Sputum sample for culture sensitivities, respiratory viral screen

  • Check urine antigens for legionella and pneumococcal (althought more commonly associated with CAP)

  • Blood and urine cultures may be required if sepsis is suspected

6. Consider saline nebulisers or mucolytics to loosen secretions

7. Physiotherapy review and incentive spirometry.

8. Encourage mobilisation if safe to do so. If bed bound ensure regular position changes.

9. Ensure adequate analgesia

10. Ensure adequate oral fluid intake, may require supplemental IVF.