Questionnaire Editor

Infected Insect Bites (Pharmacy First)

Keep focus on the canvas. Use the right panel for detail work and templates for repeatable patterns.

36 nodes 36 edges
No selection
Workspace Drag to move nodes. Scroll to zoom. Hold Shift to multi-select.
100%
00>=1>=1>=1>=10>=1>=10>=10YESNONOYES>=3 signs>=10>=10Allergy<=2No allergyNot pregnantPregnant[Sepsis]0000>=1>=1
Outcome

Offer clarithromycin for 5 days (subject to inclusion/exclusion criteria in PGD) plus self care. For penicillin-allergic patients who are NOT pregnant.

outcome_clarithromycin outcome info
Outcome

Offer erythromycin for 5 days (subject to inclusion/exclusion criteria in PGD) plus self care. For pregnant patients with penicillin allergy.

outcome_erythromycin outcome info
Outcome

Infected insect bite less likely. Recommend self care, oral antihistamine and/or topical steroids over the counter and safety netting advice. • Skin redness and itching are common and may last for up to 10 days • It is unlikely that the skin will become infected • Avoiding scratching may reduce inflammation and the risk of infection

outcome_itch_self_care_copy_1773586101064_0 info
Question

Check clarithromycin eligibility, Select ALL that apply. If none apply, select "none apply".

node_1773809687631 select_multiple
Question

Check erythromycin eligibility, Select ALL that apply. If none apply, select "none apply".

node_1773809546387 select_multiple
Referral

Urgent A&E referral via ambulance for suspected sepsis.

node_1773807698620 select
Question

Is the patient eligible for the Infected Insect Bites pathway? Select ANY that apply.

eligibility checklist select_multiple
Question

Concurrent medication for clarithromycin. Select ALL that apply. If none apply, select "none apply".

clarith_concurrent__tpl_1773813826071_5 select_multiple
Question

Check flucloxacillin eligibility, Select ALL that apply. If none apply, select "none apply".

node_1773808490822 select_multiple
Referral

Patient is not eligible for this pathway. Refer to GP or appropriate service.

outcome_not_eligible referral info
Referral

Patient falls under erythromycin PGD exclusion criteria. Onward referral — General practice or other provider as appropriate.

referral_erythromycin _failed_tpl_1773813825104_0 select
Referral

Urgent: call 999 or signpost patient to A&E immediately. Consider calculating NEWS2 Score ahead of signposting patient to A&E or calling 999 in a life-threatening emergency. Administer adrenaline if anaphylaxis suspected.

outcome_emergency referral info
Info

Do not offer an antibiotic if there are no signs or symptoms of infection. Be aware that a rapid-onset skin reaction to insect bite is likely to be an inflammatory or allergic reaction rather than an infection. Most insect bites and stings are not serious and will get better within a few hours or days, and do not need treatment with antibiotics.

intro_guidance info_panel info
Info

For patients presenting with signs and symptoms of infected insect bites. Press next to confirm.

node_1773584237067 select
Referral

Patient falls under flucloxacillin PGD exclusion criteria. Onward referral — General practice or other provider as appropriate.

referral_flucloxacillin_failed_tpl_1773813825392_1 select
Referral

Patient falls under flucloxacillin PGD exclusion criteria. Onward referral — General practice or other provider as appropriate.

referral_flucloxacillin_concurrent_tpl_1773813826180_6 select
Referral

Patient falls under clarithromycin PGD exclusion criteria. Onward referral — General practice or other provider as appropriate.

referral_clarithromycin_failed_tpl_1773813825660_2 select
Referral

Patient falls under erythromycin PGD exclusion criteria. Onward referral — General practice or other provider as appropriate.

referral_erythromycin _failed_copy_1773812608141_0_tpl_1773813826286_7 select
Question

Concurrent medication for flucloxacillin. Select ALL that apply. If none apply, select "none apply".

node_1773795405480_copy_tpl_1773813825799_3 select_multiple
Question

Consider the risk of deterioration or serious illness. Select ANY that apply.

emergency_screen decision select_multiple
Question

Does the patient meet any of the following criteria? Select ANY that apply.

lyme_screen checklist select_multiple
Referral

Onward referral: • General practice • Other provider as appropriate

outcome_lyme_referral referral info
Referral

Patient falls under clarithromycin PGD exclusion criteria. Onward referral — General practice or other provider as appropriate.

referral_clarithromycin_failed_copy_1773812939921_0_tpl_1773813825934_4 select
Question

Has it been at least 48 hours after the initial insect bite or sting?

timing_gate decision select
Outcome

Less than 48 hours since the bite. Recommend self care, oral antihistamine and/or topical steroids over the counter and safety netting advice.

outcome_too_early outcome info
Question

Is itch the principal symptom? (In the absence of other signs or symptoms of infection)

itch_check decision select
Outcome

Infected insect bite less likely. Recommend self care, oral antihistamine and/or topical steroids over the counter and safety netting advice. • Skin redness and itching are common and may last for up to 10 days • It is unlikely that the skin will become infected • Avoiding scratching may reduce inflammation and the risk of infection

outcome_itch_self_care outcome info
Outcome

Infection is not spreading. Recommend self care, oral antihistamine and/or topical steroids over the counter and safety netting advice. • Clearly demarcate the area and ask patient to monitor • Ask patient to return to pharmacy if symptoms worsen at any time OR do not improve after 3 days of over the counter treatment for pharmacist reassessment

outcome_demarcate outcome info
Question

Does the patient meet any of the following criteria? Select ANY that apply.

complication_screen checklist select_multiple
Referral

Onward referral: • Other provider as appropriate • General practice

outcome_complication_referral referral info
Question

Reported penicillin allergy (via National Care Record or Patient/Carer)?

allergy_check decision select
Outcome

Offer flucloxacillin (if no allergy) for 5 days (subject to inclusion/exclusion criteria in PGD) plus self care. Dosing by age: • 1 to <2 years: 125mg four times daily • 2–9 years: 250mg four times daily • 10–17 years and adults: 500mg four times daily Take 1 hour before or 2 hours after food.

outcome_flucloxacillin outcome info
Question

Is the patient pregnant?

pregnancy_check decision select
Question

Concurrent medication for erythromycin. Select ALL that apply. If none apply, select "none apply".

erythromycin_concurrent_tpl_1773813826396_8 select_multiple
Question

Does the patient have acute onset of ≥ 3 of the following symptoms of an infected insect bite? Select ANY that apply.

infection_assessment checklist select_multiple
Question

Does the patient meet any of the following criteria? Select ANY that apply

spreading_check checklist select_multiple

Questionnaire Editor

Questionnaire details

Active

Keep the core metadata tight and scan-friendly. Less common content sits in its own section.

Record settings Save after changing metadata or publishing state.