Treatment Escalation Level |
Management Plan and Wishes : |
ITU |
Encourage oral nutrition and hydration. ONS and consider NG feeding. IV fluids for hydration. Consider PN where NGT is not possible. Give fluids if dehydrated 20% salt poor Human Albumin Solution (HAS) if ascites and poor renal output Trial of HAS & Terlipressin for HRS AKI Haemofiltration if hepatorenal syndrome (HRS AKI) |
Hospital |
Encourage oral nutrition and hydration. ONS and consider NG feeding. Consider PN where NGT is not possible Consider IV fluids/ 20% salt poor Human albumin solution (HAS) IV for poor urine output Trial of HAS & Terlipressin for HRS AKI Haemofiltration if hepatorenal syndrome (HRS AKI) |
Home |
Encourage oral nutrition and hydration. Oral Nutrition Supplements. |
Comfort |
Offer oral comfort nutrition and hydration. Administer mouth care including oral cleaning, ice chips, artificial saliva to alleviate symptoms of dry mouth and thirst. Moisten the lips/lip moisturizers |
Treatment Escalation Level |
Management Plan and Wishes : |
ITU |
Treat infection with oral/IV antibiotics. Consider fungal therapy, prolonged courses may be required as immunocompromised |
Hospital |
Treat infection with oral/IV antibiotics. Consider fungal therapy, prolonged courses may be required as immunocompromised Glucocorticoids to treat fever, paracetamol |
Home |
Oral antibiotics. Paracetamol for fevers. Prophylaxis |
Comfort |
Fans, paracetamol and/or Glucocorticoids to treat fever. Haloperidol to treat any delirium agitation |