DE LA SALLE HEALTH SCIENCES INSTITUTE De La Salle University System College of Nursing and School of Midwifery

WARD CLASS OUTPUT (ACUTE GASTROENTERITIS)

Submitted by: Marra Camille G. Celestial, SN 12 DLS-HSI Batch 2012

Submitted to: Cavite Naval Hospital Military Nursing Elective

Date submitted: January 20, 2012

Bacterial gastroenteritis Bacterial gastroenteritis is inflammation of the stomach and intestines caused by bacteria. Causes, incidence, and risk factors Many different types of bacteria can cause bacterial gastroenteritis, including:

Campylobacter jejuni (see: Campylobacter enteritis) E. coli (see: E. coli enteritis) Salmonella (see: Salmonella enteritis) Shigella (see: Shigella enteritis) Staphylococcus Yersinia

Bacterial gastroenteritis can affect one person or a group of people who all ate the same food containing the bacteria. The condition more commonly occurs after eating at picnics, school cafeterias, large social functions, or restaurants. Bacteria may get into your food in different ways:

Meat or poultry may come into contact with intestinal bacteria when being processed Water that is used during growing or shipping may contain animal or human waste Improper food handling or preparation

Food poisoning often occurs from eating or drinking:

Any food prepared by someone who did not wash their hands properly Any food prepared using unclean cooking utensils, cutting boards, or other tools Dairy products or food containing mayonnaise (such as coleslaw or potato salad) that have been out of the refrigerator too long Frozen or refrigerated foods that are not stored at the proper temperature or are not reheated properly Raw fish or oysters Raw fruits or vegetables that have not been washed well Raw vegetable or fruit juices and dairy Undercooked meats or eggs Water from a well or stream, or city or town water that has not been treated

Symptoms Symptoms depend on the type of bacteria that caused the sickness. All types of food poisoning cause diarrhea. Other symptoms include: Abdominal cramps Abdominal pain Bloody stools Loss of appetite Nausea and vomiting

Signs and tests Your health care provider will examine you for signs of food poisoning, such as pain in the stomach and signs your body does not have as much water and fluids as it should. This is called dehydration. Laboratory tests may be done on the food or a stool sample to determine what bacteria is causing your symptoms. Treatment You will usually recover from the most common types of bacterial gastroenteritis within a couple of days. The goal is to make you feel better and avoid dehydration. These things may help you feel better if you have diarrhea:

Drink 8 to 10 glasses of clear fluids every day. Water is best. Drink at least 1 cup of liquid every time you have a loose bowel movement. Eat small meals throughout the day, instead of 3 big meals. Eat some salty foods, such as pretzels, soup, and sports drinks. Eat some high potassium foods, such as bananas, potatoes without the skin, and watered-down fruit juices.

If you have diarrhea and are unable to drink fluids because of nausea or vomiting, you may need to go to the hospital to receive fluids through a vein (IV). This is especially true for young children. If you take diuretics, talk to your health care provider. You may need to stop taking the diuretic while you are sick. Never stop or change medications without talking to your health care provider and getting specific instructions. Antibiotics are usually not prescribed for most common types of bacterial gastroenteritis, unless the diarrhea is extremely severe. Do not use over-the-counter medicines to treat diarrhea without talking to your doctor first. They should not be given to children. Expectations (prognosis) Most of the time, you get better within a week if you drink enough fluids. Rarely, kidney failure or death have occured in people with bacterial gastroenteritis. Complications Complications may include:

Anemia Body-wide (systemic) infection Not enough water in your body (dehydration) Kidney failure (rare)

RELATED ARTICLE: An Outbreak of Salmonella Gastrointestinal Illness in a Military Camp (By Vernon J. Lee, 2009) Singapore Armed Forces Introduction: Non-typhoidal Salmonellae are important causes of bacterial food-borne infection, especially in institutional settings. An outbreak of gastrointestinal infection occurred in a military camp in January 2007, and an epidemiological outbreak investigation was conducted. Materials and Methods: A survey was conducted on soldiers in the camp on their clinical symptoms, and recent meals consumed. After determining the affected meal, a subsequent survey was conducted on those who had eaten the meal. A case-control study was then performed to determine the outbreaks likely food source. Laboratory tests were also conducted to determine the bacteriological cause. Results: Of the 94 responders, 55 (58.5%) met our case definition of gastrointestinal illness. The dinner on 9 January was the most likely affected meal, with the onset of symptoms occurring within 6 to 36 hours. The mashed potato was the most likely food source with an attack rate of 80.7% for those who consumed it versus 32.7% for those who did not (P <0.01). From the multivariate analysis, the mashed potato remained the only food item independently and significantly associated with infection, with a relative risk of infection 9.49 times those who did not consume it (95% CI, 2.73-32.97). Salmonella group E was cultured from 4 individuals. Although no specific contamination was identified, the mashed potato was stored for more than 5 hours before the last serving. This study composed of 106 soldiers who ate at a celebratory dinner on January 9, 2009. Several food items like fruit punch, mashed potatoes, different fruits and lamb chops were some of the food items prepared. Out of the food items, the highest attack rate came from those who ate the mashed potatoes. The ill soldiers were tested for stool samples, all of which revealed Salmonellae infection. None of the food preparers were positive for the said microorganism when they were tested, but there was a probability of it being transferred from the soldiers who helped prepare the food. In the preparation of food for large gatherings, care should be taken in the food preparation phase involving proper handling of food but also food handlers, clean workspaces and equipment, and uncontaminated food products. Food should not be prepared too long before consumption as many gastrointestinal diseases can reproduce substantially over a few hours at the right temperatures. If a lag time between preparation and consumption is unavoidable, proper storage and reheating of the food is necessary. In addition, food samples should be collected and stored if possible, even in one-off events, to determine possible sources of outbreaks. Preparation of food in large quantities entails a risk of food contamination. This is especially so if large numbers of ingredients are mixed in multiple steps, and the food is kept for a long period after cooking before being served.