Remote prescribing and medication access — branching viva · Paeds Vivas

Prompt

A remote nurse requests ongoing antibiotics and a new anticonvulsant for a child when the nearest pharmacy is closed for the weekend.

Opening question

A remote nurse requests ongoing antibiotics and a new anticonvulsant for a child when the nearest pharmacy is closed for the weekend. Give the one-sentence definition and first safety moves. [1]

Branch 1 — classification and red flags

Classify urgency, setting and equity risks, and name red flags for escalation. [1][2]

Branch 2 — stepwise plan

Walk through assessment, call for help, stabilisation and documentation. [1]

Branch 3 — stay versus go

Explain the local-care versus retrieval decision and packaging priorities. [1][2]

Branch 4 — equity and family

Describe cultural safety, family logistics and closed-loop follow-up. [3]

References

[1]Downing J et al. Striving for Equity, Justice, and Access to Palliative Care Through Cancer and Palliative Nursing in Uganda: A Narrative Review. Semin Oncol Nurs, 2026.PMID 42173745
[2]Haimi M et al. Challenging assumptions: a tripartite assessment of medical quality, resource utilization, and equity concerns in pediatric telemedicine. BMC Med Inform Decis Mak, 2025.PMID 40796835
[3]Ciminelli AL et al. Digital health intervention to optimise heart failure management after hospital discharge in Brazil (OPT-HF): a randomised clinical trial protocol. BMJ Open, 2025.PMID 40250873
[4]Bwimba JM et al. Cost analysis of implementing community-based mass drug administration for schistosomiasis control among adult individuals using community drug distributors in Ukerewe district council, North-Western Tanzania. PLoS Negl Trop Dis, 2026.PMID 42406797

Branch 4 — equity and family

Describe cultural safety, family logistics and closed-loop follow-up. [3]

References

[1]Downing J et al. Striving for Equity, Justice, and Access to Palliative Care Through Cancer and Palliative Nursing in Uganda: A Narrative Review. Semin Oncol Nurs, 2026.PMID 42173745
[2]Haimi M et al. Challenging assumptions: a tripartite assessment of medical quality, resource utilization, and equity concerns in pediatric telemedicine. BMC Med Inform Decis Mak, 2025.PMID 40796835
[3]Ciminelli AL et al. Digital health intervention to optimise heart failure management after hospital discharge in Brazil (OPT-HF): a randomised clinical trial protocol. BMJ Open, 2025.PMID 40250873
[4]Bwimba JM et al. Cost analysis of implementing community-based mass drug administration for schistosomiasis control among adult individuals using community drug distributors in Ukerewe district council, North-Western Tanzania. PLoS Negl Trop Dis, 2026.PMID 42406797