p. Trichinosis Check box if lab results indicate: 1st Prenatal Record under Treatment or diagnosis for Positive test for Trichinoses Infection history Trichinosis called trichinellosis or Medical records document Problem list (also diagnosis or treatment of Complications this trichiniasis) Trichinosis pregnancy Factors this pregnancy A diagnoses or positive test Medical history includes: IgG ELISA 2nd Labor and Delivery Nursing Western Blot Admission Triage Form Eosinophilia and elevated under - Comments Creatinine Larvae in muscle biopsy 3rd Admission H&P under Current pregnancy history Medical history Problem list/findings q. Toxoplasmosis (Toxo) Check box if laboratory See Trichinosis Toxo evidence indicates that infection Diagnosis, treatment for Toxo A diagnosis of or positive test for occurred during pregnancy Toxoplasma gondii Do not check box if laboratory findings indicate a past A diagnosis or positive test exposure (IgG only). includes: IgM & IgG capture EIA • IFA in tissue Observation parasites in tissue PCR r. Varicella Check box if lab results indicate a See Measles Varicella positive test for Varicella or Chickenpox Positive IgM for Varicella medical records document Diagnosis or treatment of diagnosis or treatment of varicella or chickenpox Varicella.
p. Trichinosis (also called trichinellosis or trichiniasis) A diagnoses or positive test includes: IgG ELISA Western Blot Eosinophilia and elevated Creatinine Larvae in muscle biopsy Check box if lab results indicate: Positive test for Trichinoses Medical records document diagnosis or treatment of Trichinosis 1st Prenatal Record under Infection history Problem list Complications this pregnancy Factors this pregnancy Medical history 2nd Labor and Delivery Nursing Admission Triage Form under - Comments 3rd Admission H&P under Current pregnancy history Medical history Problem list/findings Treatment or diagnosis for Trichinosis q. Toxoplasmosis (Toxo) A diagnosis of or positive test for Toxoplasma gondii A diagnosis or positive test includes: • IgM & IgG capture EIA IFA in tissue Observation parasites in tissue PCR Check box if laboratory evidence indicates that infection occurred during pregnancy Do not check box if laboratory findings indicate a past exposure (IgG only). See Trichinosis Toxo Diagnosis, treatment for Toxo r. Varicella Positive IgM for Varicella Check box if lab results indicate a positive test for Varicella or medical records document diagnosis or treatment of Varicella. See Measles Varicella Chickenpox Diagnosis or treatment of varicella or chickenpox
Guide_MPM_BC_Facility_Worksheet_Guidelines.10.14.docx