trust clinical guideline
|
|
- Moris Barton
- 7 years ago
- Views:
Transcription
1 CG01 VERSION 1.0 1/12 Guideline ID CG01 Version 1.1 Title Approved by Acute Coronary Syndromes and Stable Angina Clinical Effectiveness Group Date Issued 01/10/2014 Review Date 31/09/2017 Directorate Authorised Staff Medical Ambulance Care Assistant Emergency Care Assistant Student Paramedic Advanced Technician Paramedic (non-ecp) Nurse (non-ecp) ECP Doctor Clinical Publication Category Guidance (Green) - Deviation permissible; Apply clinical judgement 1. Scope 1.1 This clinical guideline covers the assessment and management of patients with recent onset chest pain or discomfort of suspected cardiac origin. 2. Background and Definitions 2.1 Coronary heart disease (CHD) is the most common cause of death in the UK, with around one in five men and one in seven women dying from the disease. CHD is also the most common cause of premature death. Although the death rate from CHD has been decreasing since the early 1970s, the death rate in the UK is still higher than many countries in Western Europe. 2.2 Over 2 million people are living with CHD in the UK, with around 275,000 people suffering a myocardial infarction every year. 2.3 Acute Coronary Syndrome (ACS) is defined as a condition in which there is an event in a coronary artery with plaque rupture or erosion, or coronary dissection, with the formation of an intra-coronary thrombus. The term therefore encompasses both unstable angina and myocardial infarction.
2 CG01 VERSION 1.0 2/ ST-elevation myocardial infarction (STEMI) is defined as myocardial infarction with raised ST segment. The criteria for STEMI is at least 1mm elevation of the ST segment in contiguous limbs leads or 2mm elevation of ST segment in at least 2 contiguous chest leads. A 1mm raise in an ST segment in an isolated lead could be physiological and have no clinical significance. 2.5 The term chest pain is used throughout this guideline to mean chest pain or discomfort. 3. Guidance 3.1 Assessment Patients suffering from chest pain of suspected cardiac origin are at high risk of VF arrest. Ensure a defibrillator is taken to the scene and if ACS is suspected the defibrillator must remain with the patient until handover at hospital Check immediately whether the patient currently has chest pain. If they are pain free, check when their last episode of pain was, particularly if it was within the last 12 hours Determine whether the chest pain is likely to be cardiac related and therefore whether this guideline is relevant, by considering: History of the chest pain; Presence of cardiovascular risk factors; History of ischaemic heart disease and any previous treatment; Previous investigations for chest pain; The nature of the pain (PQRSTA) Initially assess for any of the following symptoms, which may indicate an ACS: Pain in the chest and/or other referred areas (for example the arms, back or jaw) lasting longer than 15 minutes; Chest pain associated with nausea and vomiting, marked sweating, breathlessness or particularly a combination of these; Chest pain associated with haemodynamic instability; New onset chest pain, or abrupt deterioration in previously stable angina, with recurrent chest pain occurring frequently with little or no exertion, and with episodes often lasting longer than 15 minutes.
3 CG01 VERSION 1.0 3/ Do not: Use people s response to glyceryl trinitrate (GTN) to make a diagnosis, as there is no evidence that this is a reliable indicator that pain is of a cardiac origin; Assess symptoms of an ACS differently in men and women; not all people with an ACS present with central chest pain as the predominant feature; Assess symptoms of an ACS differently in ethnic groups; although the risk of ACS is higher in some ethnic groups, there are no major differences in symptoms Take a resting 12-lead ECG as soon as possible. Unless the patient presents with typical symptoms of acute myocardial infarction (AMI) this is often best achieved before moving the patient. 3.2 Diagnosis Following assessment identify which pathway best fits the patient s presentation: 3.3 Pathway Management of ST elevation or LBBB with history and signs of AMI should start as soon as it is suspected, and should not delay transfer to hospital. Follow the STEMI Care Pathway detailed in Appendix The preferred treatment for STEMI is Primary Percutaneous Coronary Intervention (PPCI); refer to Appendix 2 for details of local care pathways.
4 CG01 VERSION 1.0 4/ In East and West Divisions pre-hospital thrombolysis remains available on a small number of strategically placed vehicles. When PPCI is not available in these Divisions due to either the excessive travel time to a centre, service disruptions or adverse weather, pre-hospital thrombolysis should be considered (see Appendix 3 for checklist). Standard Operating Procedure C17: Emergency Availability of Tenecteplase (TNK) details how to request a vehicle carrying TNK. Within North Division, the patient must instead be transported to the nearest ED for consideration of thrombolysis. Pathway 1 Pathway 2 Pathway 3 ST elevation in two or more anatomically contiguous leads (1mm raised in limb leads or 2mm in chest leads) or LBBB with history and symptoms of AMI. No ST elevation and patient currently has cardiac chest pain or No ST elevation and patient is currently pain free, but had cardiac chest pain in the last 12 hours and 12 lead ECG is abnormal e.g. Q waves and T wave changes. Patient had chest pain in the last 12 hours, but is now pain free and 12 lead ECG is normal Deliver generic patient care: Record pain score and offer entonox whilst obtaining IV access; The preferred analgesia is intravenous morphine. Continue entonox if unable to administer morphine (oral morphine may be considered if IV access cannot be achieved); Administer GTN in accordance with JRCALC guidelines; Administer 300mg aspirin in accordance with JRCALC guidelines. Monitor pulseoximetry. Do not routinely administer oxygen; oxygen should only be administered when oxygen saturation are less than 94%, aiming for an SpO 2 of 94-98%. For people with chronic obstructive pulmonary disease who are at risk of hypercapnic respiratory failure, aim to achieve a target SpO 2 of 88-92%, using capnography where available; Monitor people with acute chest pain, using clinical judgement to decide on the frequency of observations: Check pain relief is, record second and subsequent pain scores and administer further analgesia as required; Pulse and blood pressure; Oxygen saturations; Repeat 12 lead ECG; Minimise on-scene time; Convey to nearest available ppci centre under emergency driving conditions with an ATMIST pre-alert.
5 CG01 VERSION 1.0 5/ A defibrillator must remain with the patient during the transfer at hospital, in case it is required. It is not necessary to apply defibrillator pads to ACS patients as a precaution in case they should experience a cardiac arrest either en-route to hospital, or during the journey between the vehicle and the catheter laboratory. The exception would be if the senior clinician caring for the patient deems that they are at immanent risk of cardiac arrest. 3.4 Pathway Patient requires urgent assessment at nearest appropriate acute hospital Emergency Department (or Coronary Care Unit where local arrangements exist). Deliver generic care as detailed in Section Pathway NICE guidelines recommend that if an ACS is suspected and the patient has had chest pain in the last 12 hours and are now pain free with a normal resting 12- lead ECG, they should be referred for urgent same-day assessment. Options for urgent same-day assessment are dependent on the availability of local pathways. Contact acute hospital medical assessment or coronary care unit to discuss case and agree care plan. This may require the patient to attend an Emergency Department. The need for ambulance conveyance should be determined on a case by case basis by the senior clinician on-scene. 3.6 National Ambulance Clinical Quality Indicator Ambulance clinicians must ensure that the high quality of care they deliver is reflected through the achievement of the National ACQI for the management of STEMI, which is divided into three components: The percentage of patients suffering a STEMI who are directly transferred to a centre capable of delivering primary percutaneous coronary intervention (PPCI) and receive angioplasty within 150 minutes of call; The percentage of patients suffering a STEMI receiving thrombolysis within 60 minutes of call; The percentage of patients suffering a STEMI who receive an appropriate care bundle The care bundle for STEMI includes: Administration of aspirin in accordance with JRCALC; Administration of GTN in accordance with JRCALC; Recording of two pain scores; Providing analgesia; Recording pulse oximtery (SpO 2 ).
6 CG01 VERSION 1.0 6/12 4. Documentation 4.1 In line with Trust Policy, a Patient Clinical Record must be completed and annotated appropriately. Clinicians must ensure that the STEMI care bundle detailed in is delivered to all appropriate patients. Any exceptions, such as GTN not being administered due to hypotension, must be recorded in the procedural exclusions section. Any deviation from this clinical guideline must be recorded, with any potential or actual adverse event reported through the incident reporting system. 5. References 1. National Institute for Health and Clinical Excellence (2010) Chest pain of recent onset: Assessment and diagnosis of recent onset chest pain or discomfort of suspected cardiac origin. NICE.
7 CG01 VERSION 1.0 7/12 Appendix 1 - STEMI Care Pathway Obtain resting 12 lead ECG as soon as possible If unable to confirm ST elevation, however AMI is clinically suspected, convey to local ED under emergency driving with pre-alert requesting urgent review on arrival. (If telemetry available seek advice if required) Chest pain of suspected cardiac origin ECG interpretation by ambulance clinician JRCALC Analgesia GTN Aspirin Oxygen Pain Scores Ambulance clinician recognises ST elevation or LBBB and patient symptomatic of AMI Current cardiac chest pain without ST elevation or concerning acute ECG changes in the absence of chest pain Pathway 1 Pathway 2 Pre-alert PPCI centre and confirm acceptance. Convey under emergency driving conditions. Consider pre-hospital thrombolysis if PPCI is not available (within East/West Division). Convey to local appropriate ED/CCU. Pre-alert as appropriate Additional Treatment: IV access. Monitor ness of pain relief. Anti-emetic if required for treatment of nausea and vomiting
8 CG01 VERSION 1.0 8/12 Appendix 2 - PPCI Centre Locations, Availability and Contact Numbers Operating Period Pre-alert / Cath Lab Phone Bristol Heart Institute 24/7 Cheltenham General Mon-Fri (Excluding Bank holidays) RESTRICT Derriford 24/7 Dorset County Great Western Mon-Fri 09:00-17:00 (Excluding Bank holidays) Mon-Fri (Excluding Bank holidays) John Radcliffe, Oxford 24/7 Musgrove Park 24/7 North Devon District No PPCI divert to RD&E Royal Bournemouth 24/7 Royal Cornwall 24/7 Royal Devon and Exeter 24/7 Royal United Bath Mon-Fri (Excluding Bank holidays) Salisbury District Southampton General Mon - Fri hrs (excluding bank holidays) 24/7 Torbay 24/7 (Please give callsign and contact number as part of pre-alert).
9 CG01 VERSION 1.0 9/12 Southampton General Access via Emergency Department ambulance entrance. ACS nurse will escort to Cath Lab / CCU. If no ACS nurse in attendance, immediately notify senior ED staff. Bristol Heart Institute, Bristol If not met at dedicated ambulance entrance doors, ensure the alert buzzer is activated to notify BHI staff of arrival. John Radclifffe, Oxford Enter the John Radcliffe site via Headley Way. At the first roundabout turn right. Drive past the West Wing/Childrens hospital towards the direction of A&E. At the end of the west wing, after the zebra crossing, take the first turning left. Pull up into the ambulance bay, if the PPCI team are not waiting for you at the door press the bell on the left hand side.
10 CG01 VERSION /12 Appendix 3
Acute Coronary Syndrome. What Every Healthcare Professional Needs To Know
Acute Coronary Syndrome What Every Healthcare Professional Needs To Know Background of ACS Acute Coronary Syndrome (ACS) is an umbrella term used to cover a spectrum of clinical conditions that are caused
More information6/5/2014. Objectives. Acute Coronary Syndromes. Epidemiology. Epidemiology. Epidemiology and Health Care Impact Pathophysiology
Objectives Acute Coronary Syndromes Epidemiology and Health Care Impact Pathophysiology Unstable Angina NSTEMI STEMI Clinical Clues Pre-hospital Spokane County EMS Epidemiology About 600,000 people die
More informationGENERAL HEART DISEASE KNOW THE FACTS
GENERAL HEART DISEASE KNOW THE FACTS WHAT IS Heart disease is a broad term meaning any disease affecting the heart. It is commonly used to refer to coronary heart disease (CHD), a more specific term to
More informationCoronary Artery Disease leading cause of morbidity & mortality in industrialised nations.
INTRODUCTION Coronary Artery Disease leading cause of morbidity & mortality in industrialised nations. Although decrease in cardiovascular mortality still major cause of morbidity & burden of disease.
More informationtrust clinical guideline
CG23 VERSION 1.0 1/7 Guideline ID CG23 Version 1.0 Title Approved by Transient Loss of Consciousness Clinical Effectiveness Group Date Issued 01/01/2013 Review Date 31/12/2016 Directorate Authorised Staff
More informationtrust clinical guideline
CG04 VERSION 1.0 1/5 Guideline ID CG04 Version 1.0 Title Approved by Allergic Reactions Clinical Effectiveness Group Date Issued 01/01/2013 Review Date 31/12/2016 Directorate Authorised Staff Clinical
More informationManagement of Acute Coronary Syndrome / NSTEMI
CLINICAL GUIDELINE Management of Acute Coronary Syndrome / NSTEMI For use in (clinical areas): For use by (staff groups): For use for (patients): Document owner: Status: All clinical areas Medical and
More informationREFERRAL HOSPITAL. The Importance of Door In Door Out Time DIDO
REFERRAL HOSPITAL The Importance of Door In Door Out Time DIDO Time to Treatment is critical for STEMI patients For patients with ST-segment elevation myocardial infarction (STEMI), percutaneous coronary
More informationHEALTH CARE PROFESSIONAL (HCP) ADMISSIONS
HEALTH CARE PROFESSIONAL (HCP) ADMISSIONS Information Booklet 0 Contents Page No Content 1 Index 2 Introduction What is a HCP Admission? 3 Booking Transport Who is authorised to book HCP Admissions? Who
More informationURN: Family name: Given name(s): Address:
State of Queensland (Queensland Health) 2015 Licensed under: http://creativecommons.org/licenses/by-nc-nd/3.0/au/deed.en Contact: Clinical_Pathways_Program@health.qld.gov.au Facility:... Clinical pathways
More informationRedefining the NSTEACS pathway in London
Redefining the NSTEACS pathway in London Sotiris Antoniou Consultant Pharmacist, Cardiovascular Medicine, Barts and The London NHS Trust and Project Lead, North East London Cardiovascular and Stroke Network
More informationS Hutton, A Inglis, C McKiernan, S Hearns, P Campbell, M Lindsay
Emergency Medical Retrieval Service (EMRS) www.emrs.scot.nhs.uk Standard Operating Procedure Public Distribution Title Acute Coronary Syndrome Version 4 Related Documents Author Alan Exton Reviewer S Hutton,
More informationA PATIENT S GUIDE TO SECONDARY PREVENTION IN ACUTE CORONARY SYNDROME (ACS)
A PATIENT S GUIDE TO SECONDARY PREVENTION IN ACUTE CORONARY SYNDROME (ACS) This medicine is subject to additional monitoring. This will allow quick identification of new safety information. If you get
More informationNurse Practitioner. CLINICAL PROTOCOL Chest Pain
Nurse INTRODUCTION: Patients presenting with chest pain require rapid evaluation. Myocardial ischaemia should be considered in all patients presenting with chest pain. Assessment of pain type and referral,
More informationIs it really so? : Varying Presentations for ACS among Elderly, Women and Diabetics. Yen Tibayan, M.D. Division of Cardiovascular Medicine
Is it really so? : Varying Presentations for ACS among Elderly, Women and Diabetics Yen Tibayan, M.D. Division of Cardiovascular Medicine Case Presentation 69 y.o. woman calls 911 with the complaint of
More informationHeart Attack: What You Need to Know
A WorkLife4You Guide Heart Attack: What You Need to Know What is a Heart Attack? The heart works 24 hours a day, pumping oxygen and nutrient-rich blood to the body. Blood is supplied to the heart through
More informationWhat is a Heart Attack? 1,2,3
S What is a Heart Attack? 1,2,3 Heart attacks, otherwise known as myocardial infarctions, are caused when the blood supply to a section of the heart is suddenly disrupted. Without the oxygen supplied by
More informationStent for Life Initiative How can we improve system delay and patients delay in STEMI
Stent for Life Initiative How can we improve system delay and patients delay in STEMI Z. Kaifoszova SFL Initiative Europe 2011 Stent for Life Initiative 10 countries participate in the program Declaration
More informationAmbulance Trust Feedback Report. Progress in improving stroke care
Feedback Report Ambulance Trust Feedback Report Progress in improving stroke care Progress in improving stroke care Ambulance Trust Feedback Report Introduction In February 2010 we published a report on
More informationTips and Tricks to Demystify 12 Lead ECG Interpretation
Tips and Tricks to Demystify 12 Lead ECG Interpretation Mission: Lifeline North Dakota Regional EMS and Hospital Conference Samantha Kapphahn, DO Essentia Health- Interventional Cardiology June 5th, 2014
More informationNAME OF THE HOSPITAL: 1. Coronary Balloon Angioplasty: M7F1.1/ Angioplasty with Stent(PTCA with Stent): M7F1.3
1. Coronary Balloon Angioplasty: M7F1.1/ Angioplasty with Stent(PTCA with Stent): M7F1.3 1. Name of the Procedure: Coronary Balloon Angioplasty 2. Select the Indication from the drop down of various indications
More informationCBT/OTEP 243 Aspirin Administration for ACS
Seattle-King County EMS Seattle-King County Emergency Medical Services Division Public Health - Seattle/King County 401 5th Avenue, Suite 1200 Seattle, WA 98104 (206) 296-4693 February 2009 CBT/OTEP 243
More informationTeam Leader. Ensures high-quality CPR at all times Assigns team member roles Ensures that team members perform well. Bradycardia Management
ACLS Megacode Case 1: Sinus Bradycardia (Bradycardia VF/Pulseless VT Asystole Out-of-Hospital Scenario You are a paramedic and arrive on the scene to find a 57-year-old woman complaining of indigestion.
More informationOfficial Online ACLS Exam
\ Official Online ACLS Exam Please fill out this form before you take the exam. Name : Email : Phone : 1. Hypovolemia initially produces which arrhythmia? A. PEA B. Sinus tachycardia C. Symptomatic bradyarrhythmia
More informationRISK STRATIFICATION for Acute Coronary Syndrome in the Emergency Department
RISK STRATIFICATION for Acute Coronary Syndrome in the Emergency Department Sohil Pothiawala FAMS (EM), MRCSEd (A&E), M.Med (EM), MBBS Consultant Dept. of Emergency Medicine Singapore General Hospital
More informationCOUNTY OF KERN EMERGENCY MEDCAL SERVICES DEPARTMENT. EMS Aircraft Dispatch-Response-Utilization Policies & Procedures
COUNTY OF KERN EMERGENCY MEDCAL SERVICES DEPARTMENT Final - May 2, 2002 Russ Blind Interim Director Robert Barnes, M.D. Medical Director TABLE OF CONTENTS Section: Topic: Page #: I. Definitions 3-4 II.
More informationEMR Tutorial Acute Coronary Syndrome
EMR Tutorial Acute Coronary Syndrome How to find the Acute Coronary Syndrome AAA Home Page 1 of 26 Master Tool Bar Icon When the Template button is clicked you will be presented with the preference list.
More informationAssessment, diagnosis and specialist referral of adults (>16 years) with an episode of transient loss of consciousness (TLoC) or a blackout.
Assessment, diagnosis and specialist referral of adults (>16 years) with an episode of transient loss of consciousness (TLoC) or a blackout. TLoC is common huge variation in management range of clinicians
More informationHELPING US TO HELP YOU
HELPING US TO HELP YOU Page 1 of 8 The Royal Surrey County Hospital Patient Transport Services Does Your Patient Require Patient Transport? Hospital-Funded Patient Transport can only be provided to patients
More informationConsultation Draft: Clinical Care Standard for Acute Coronary Syndrome December 2013
TRIM: 90512 Consultation Draft: Clinical Care Standard for Acute Coronary Syndrome December 2013 Commonwealth of Australia 2013 This work is copyright. It may be reproduced in whole or in part for study
More information3/2/2010 Post CABG R h e bili a i tat on Ahmed Elkerdany Professor o f oof C ardiac Cardiac Surgery Ain Shams University 1
Post CABG Rehabilitation i Ahmed Elkerdany Professor of Cardiac Surgery Ain Shams University 1 Definition Cardiac rehabilitation services are comprehensive, long-term programs involving : medical evaluation.
More informationEarly Warning Scores (EWS) Clinical Sessions 2011 By Bhavin Doshi
Early Warning Scores (EWS) Clinical Sessions 2011 By Bhavin Doshi What is EWS? After qualifying, junior doctors are expected to distinguish between the moderately sick patients who can be managed in the
More informationCoronary Heart Disease (CHD) Brief
Coronary Heart Disease (CHD) Brief What is Coronary Heart Disease? Coronary Heart Disease (CHD), also called coronary artery disease 1, is the most common heart condition in the United States. It occurs
More informationHow To Get On A Jet Plane
Nature of disability Hospital Details TEL : +91 22 6711 6618 / 09 l FAX : +91 22 26156290 +91 11 49637953 +91 44 22568009 +91 33 25111359 Information Sheet for Guest Requiring Medical Clearance (to be
More informationGuideline Health Service Directive
Guideline Health Service Directive Guideline QH-HSDGDL-025-3:2014 Effective Date: 17 January 2014 Review Date: 17 January 2016 Supersedes: qh-hsdptl-025-3:2012 Patient Access and Flow Health Service Directive
More informationPost-MI Cardiac Rehabilitation. Mark Mason Consultant Cardiologist Harefield Hospital Royal Brompton and Harefield NHS Foundation Trust
Post-MI Cardiac Rehabilitation Mark Mason Consultant Cardiologist Harefield Hospital Royal Brompton and Harefield NHS Foundation Trust 'the sum of activities required to influence favourably the underlying
More informationMedical Section. Email : acmedical@aircanada.ca. Fax : 1 888 334-7717 (toll-free) or 514 828-0027
Departure Date: Medical Section Hours of Operation MON-FRI 06:00-20:00 EST SAT-SUN 06:00-18 :00 EST Email : acmedical@aircanada.ca Fax : 1 888 334-7717 (toll-free) or 514 828-0027 Telephone : 1 800 667-4732
More informationGlossary of Terms and Acronyms
Glossary of Terms and Acronyms Term/Abbreviation Accident and Emergency (A&E) Service Advanced Medical Priority Dispatch System (AMPDS) Ambulance Quality Indicators (AQIs) Ambulance Service Cardiovascular
More informationLevel 1 Tower C Global Business Park MG Road Gurgaon,122 002 India T+91 124 406 2500 F+91 124 406 8536 goindigo.in
APPLICATION FOR CARRIAGE OF MEDICAL PASSENGERS Detailed Medical Certificate must accompany this completed form. Medical Passenger Completed Application to be forwarded to the Medical Department DEL for
More informationHeart Attack Your quick guide
Heart Attack Your quick guide Coronary heart disease is the UK s single biggest killer. For over 50 years we ve pioneered research that s transformed the lives of people living with heart and circulatory
More informationThe Scottish Ambulance Service Improving Care, Reducing Costs. Working together for better patient care
The Scottish Ambulance Service Improving Care, Reducing Costs Working together for better patient care Key points The Scottish Ambulance Service is seeing more people, faster, and offering better quality
More informationThe largest clinical study of Bayer's Xarelto (rivaroxaban) Wednesday, 14 November 2012 07:38
Bayer HealthCare has announced the initiation of the COMPASS study, the largest clinical study of its oral anticoagulant Xarelto (rivaroxaban) to date, investigating the prevention of major adverse cardiac
More informationThe National Service Framework for Cardiac Disease: Strategic Aims and Implementation A Cardiac Work Programme for Wales
The National Service Framework for Disease: Strategic Aims and A Work Programme for Wales Disease Strategic Framework 2008-11 1 CONTENTS Page 1. Introduction 3 2. Part 1 Strategic Aims 3 3. Part 2 Standard
More informationCARDIAC REHABILITATION PROGRAM
CARDIAC REHABILITATION PROGRAM Preparation for the Cardiac Rehabilitation Program After your heart problem is stable, your physician or cardiologist will refer you to the Cardiac Rehabilitation program.
More informationEEI Networking Event 2011 Copyright 2011 Mobigator Technology Group. All rights reserved.
1 Healthcare Solutions MOBIGATOR, THE COMPANY 2 Established 1994 in New York with an outstanding track record and reputation in technology advisory, management and development. Global business presence
More informationURN: Family name: Given name(s): Address:
The State of Queensland (Queensland Health) 2012 Contact CIM@health.qld.gov.au Facility: Clinical Pathways Never Replace Clinical Judgement Care Outlined In This Pathway Must be Altered If It Is Not Clinically
More informationACCIDENT AND EMERGENCY DEPARTMENT/CARDIOLOGY
Care Pathway Triage category ATRIAL FIBRILLATION PATHWAY ACCIDENT AND EMERGENCY DEPARTMENT/CARDIOLOGY AF/ FLUTTER IS PRIMARY REASON FOR PRESENTATION YES NO ONSET SYMPTOMS OF AF./../ TIME DURATION OF AF
More information2013/14 QUALITY ACCOUNT
2013/14 QUALITY ACCOUNT Quality means doing it right when no-one is looking. Henry Ford Contents Summary and introduction...4 Part 1: statements of quality and accountability...7 Part 2: our priorities
More informationMission: Lifeline Recommendations for Criteria for STEMI Systems of Care
Mission: Lifeline Recommendations for Criteria for STEMI Systems of Care The Mission: Lifeline Certification Program will acknowledge STEMI Systems, EMS, Non-PCI/STEMI Referral Centers and PCI/STEMI Receiving
More informationFuture National Clinical Priorities for Ambulance Services in England
Background Future National Clinical Priorities for Ambulance Services in England National Ambulance Service Medical Directors (NASMeD) April 2014 Ambulance services have delivered significant improvements
More informationDO YOU LIVE IN A CARDIAC READY COMMUNITY?
DO YOU LIVE IN A CARDIAC READY COMMUNITY? If someone in your community suffers a sudden cardiac arrest tomorrow, how likely is he or she to survive due to rapid access to life-saving treatment? Cities
More informationACLS PRE-TEST ANNOTATED ANSWER KEY
ACLS PRE-TEST ANNOTATED ANSWER KEY June, 2011 Question 1: Question 2: There is no pulse with this rhythm. Question 3: Question 4: Question 5: Question 6: Question 7: Question 8: Question 9: Question 10:
More informationNational Medicines Information Centre
National Medicines Information Centre VOLUME 11 NUMBER 4 2005 ST. JAMES S HOSPITAL DUBLIN 8 TEL 01-4730589 or 1850-727-727 FAX 01-4730596 www.nmic.ie For personal use only. Not to be reproduced without
More informationWMAS Clinical Guidelines CLN PRO - 027 I Version - 4
WMAS Clinical Guidelines CLN PRO - 027 I Version - 4 Guideline ID CLN PRO - 027 Version Version 4 Title WMAS Stroke Guidelines Approved by Clinical Steering Group Date Issued 4 May 2016 Review Date May
More informationStress is linked to exaggerated cardiovascular reactivity. 1) Stress 2) Hostility 3) Social Support. Evidence of association between these
Psychosocial Factors & CHD Health Psychology Psychosocial Factors 1) Stress 2) Hostility 3) Social Support Evidence of association between these psychosocial factors and CHD Physiological Mechanisms Stress
More informationMarilyn Borkgren-Okonek, APN, CCNS, RN, MS Suburban Lung Associates, S.C. Elk Grove Village, IL
Marilyn Borkgren-Okonek, APN, CCNS, RN, MS Suburban Lung Associates, S.C. Elk Grove Village, IL www.goldcopd.com GLOBAL INITIATIVE FOR CHRONIC OBSTRUCTIVE LUNG DISEASE GLOBAL STRATEGY FOR DIAGNOSIS, MANAGEMENT
More informationOxygen - update April 2009 OXG
PRESENTATION Oxygen (O 2 ) is a gas provided in compressed form in a cylinder. It is also available in liquid form, in a system adapted for ambulance use. It is fed via a regulator and flow meter to the
More informationCARDIOLOGY ROTATION GOALS AND OBJECTIVES
CARDIOLOGY ROTATION GOALS AND OBJECTIVES PGY-1 Core Medicine Rotation The trainee will have the opportunity to develop clinical skills, the ability to analyze patients problems, and make treatment plans
More informationHAAD JAWDA Quality KPI; waiting times. December 2015
HAAD JAWDA Quality KPI; waiting times December 2015 Page 1 of 13 Type: Waiting Time Indicator Indicator Number: WT001 Primary Care Appointment- Outpatient Setting Time to see a HAAD licensed family physician
More informationChest Pain Evaluation (NSW Chest Pain Pathway)
Policy Directive Ministry of Health, SW 73 Miller Street orth Sydney SW 2060 Locked Mail Bag 961 orth Sydney SW 2059 Telephone (02) 9391 9000 Fax (02) 9391 9101 http//www.health.nsw.gov.au/policies/ Chest
More informationEXHIBIT H SETTLEMENT ELIGIBILITY CRITERIA. a) pharmacy records reflecting the dispensing of Bextra and/or Celebrex to the Class Member; or
EXHIBIT H SETTLEMENT ELIGIBILITY CRITERIA 1. PRODUCT IDENTIFICATION DOCUMENTATION In order to be eligible for compensation under the Settlement Agreement, each Claimant must provide evidence of the Class
More informationIschemic Heart Disease: Angina Pectoris
Ischemic Heart Disease: Angina Pectoris Robert J. Straka, Pharm.D. FCCP Associate Professor University of Minnesota College of Pharmacy Minneapolis, Minnesota, USA strak001@umn.edu Learning Objectives
More informationMonitoring acute coronary syndrome using national hospital data An information paper on trends and issues
Monitoring acute coronary syndrome using national hospital data An information paper on trends and issues Australian Institute of Health and Welfare Canberra Cat. no. CVD 57 The Australian Institute of
More informationRGN JOY LAUDE WATFORD GENERAL HOSPITAL, ENGLAND
RGN JOY LAUDE WATFORD GENERAL HOSPITAL, ENGLAND Monitor patient on the ward to detect trends in vital signs and to manage accordingly To recognise deteriorating trends and request relevant medical/out
More informationS9 Administer thrombolytic treatment in acute ischaemic stroke
S9 Administer thrombolytic treatment in acute ischaemic Screening and initiating treatment, overseeing competency of treatment About this workforce competence This competence is about the emergency administration
More informationNational Early Warning Score. National Clinical Guideline No. 1
National Early Warning Score National Clinical Guideline No. 1 February 2013 The National Early Warning Score and COMPASS Education programme project is a work stream of the National Acute Medicine Programme,
More informationDr Anne Weaver London s Air Ambulance CODE RED THE BLEEDING PATIENT
Dr Anne Weaver London s Air Ambulance CODE RED THE BLEEDING PATIENT Objectives Describe the background to Code Red Describe our Standard Operating Procedure Share our data The bleeding problem Major haemorrhage
More informationAutomatic External Defibrillators
Last Review Date: May 27, 2016 Number: MG.MM.DM.10dC2 Medical Guideline Disclaimer Property of EmblemHealth. All rights reserved. The treating physician or primary care provider must submit to EmblemHealth
More informationMission: Lifeline EMS Recognition Guide
Mission: Lifeline EMS Recognition Guide This Mission: Lifeline EMS Recognition Guide was developed to provide information about Mission: Lifeline EMS Recognition processes and criteria. If you have any
More informationCardiovascular diseases. pathology
Cardiovascular diseases pathology Atherosclerosis Vascular diseases A disease that results in arterial wall thickens as a result of build- up of fatty materials such cholesterol, resulting in acute and
More informationNATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE. Health Technology Appraisal. Drugs for the treatment of pulmonary arterial hypertension
NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE Health Technology Appraisal Drugs for the treatment of Remit / Appraisal objective: Final scope To appraise the clinical and cost effectiveness of
More informationINTERDISCIPLINARY CLINICAL MANUAL Policy and Procedure
INTERDISCIPLINARY CLINICAL MANUAL Policy and Procedure TITLE: Management of Angina in NUMBER: Effective Date: January 2014 Page 1 of 6 Applies To: Interdisciplinary Clinical Manual Cardiac Rehabilitation
More informationCardiac Catheterization Lab Procedures
UW MEDICINE PATIENT EDUCATION Cardiac Catheterization Lab Procedures This handout describes how cardiac catheterization works. It also explains how to prepare for your procedure and the self-care needed
More informationSeeing ambulance services in a different light
factsheet June 2010 Seeing ambulance services in a different light More than a patient transport service Key points NHS ambulance services face some of the most demanding performance targets in the world.
More information- Appreciate the importance of chest pain as a presenting symptom. - Feel more confident about the recognition and early management of chest pain
Acute Chest Pain Objectives By reading this material you should be able to - Appreciate the importance of chest pain as a presenting symptom - Feel more confident about the recognition and early management
More informationImplementing a Prehospital 12-Lead Program
Implementing a Prehospital 12-Lead Program Corey M. Slovis, M.D. Professor and Chairman Department of Emergency Medicine Vanderbilt University Medical Center Medical Director, Metro Nashville Fire Department
More informationRivaroxaban for acute coronary syndromes
Northern Treatment Advisory Group Rivaroxaban for acute coronary syndromes Lead author: Nancy Kane Regional Drug & Therapeutics Centre (Newcastle) May 2014 2014 Summary Current long-term management following
More informationImproving PCI Benchmark times in a Non-PCI World
Improving PCI Benchmark times in a Non-PCI World May 2011 St David s Georgetown Hospital, Georgetown Texas Margaret Connors BSN, RN, CEN Kirk Sinclair BSN, RN, CEN National Processes/ Mission LifeLine
More informationCommunity health care services Alternatives to acute admission & Facilitated discharge options. Directory
Community health care services Alternatives to acute admission & Facilitated discharge options Directory Introduction The purpose of this directory is to provide primary and secondary health and social
More informationSummary of EWS Policy for NHSP Staff
Summary of EWS Policy for NHSP Staff For full version see CMFT Intranet Contact Sister Donna Egan outreach coordinator bleep 8742 Tel: 0161 276 8742 Introduction The close monitoring of patients physiological
More informationSUBJECT: PRIVATE PROVIDER AGENCY (EMT, PARAMEDIC, MICN) TRANSPORT/RESPONSE GUIDELINES REFERENCE NO. 517
DEPARTMENT OF HEALTH SERVICES COUNTY OF LOS ANGELES SUBJECT: PRIVATE PROVIDER AGENCY (EMT, PARAMEDIC, MICN) TRANSPORT/RESPONSE PURPOSE: To provide guidelines for private ambulance providers handling requests
More informationTaking Healthcare to the Patient. Transforming NHS Ambulance Services
Taking Healthcare to the Patient Transforming NHS Ambulance Services Acknowledgements Photos on pages 15, 48 courtesy of Essex Ambulance Service NHS Trust Cover, 10, 12, 18, 24, 34, 40 courtesy of London
More informationIf you do not wish to print the entire pre-test you may print Page 2 only to write your answers, score your test, and turn in to your instructor.
This is a SAMPLE of the pretest you can access with your AHA PALS Course Manual at Heart.org/Eccstudent using your personal code that comes with your PALS Course Manual The American Heart Association strongly
More informationChristopher M. Wright, MD, MBA Pioneer Cardiovascular Consultants Tempe, Arizona
Christopher M. Wright, MD, MBA Pioneer Cardiovascular Consultants Tempe, Arizona Areas to be covered Historical, current, and future treatments for various cardiovascular disease: Atherosclerosis (Coronary
More informationPOLICIES AND PROCEDURES. CODE BLUE Adult / Pediatric. I.D. Number: 1012. Authorization: [x] Advanced Life Support Committee [x] SHR Nursing Practice
POLICIES AND PROCEDURES Title: CODE BLUE Adult / Pediatric I.D. Number: 1012 Authorization: [x] Advanced Life Support Committee [x] SHR Nursing Practice Source: Advanced Life Support Committee Cross Index:
More informationAn Informative Guide for Heart Catheterization Patients & Families
An Informative Guide for Heart Catheterization Patients & Families What is a Cardiac Cath? Cardiac catheterization is a procedure used to diagnose and treat patients who have various forms of heart disease.
More informationCardiac Rehabilitation CARDIAC REHABILITATION HS-091. Policy Number: HS-091. Original Effective Date: 3/16/2009
Easy Choice Health Plan, Inc. Harmony Health Plan of Illinois, Inc. M issouri Care, Inc. Ohana Health Plan, a plan offered by WellCare Health Insurance of Arizona, Inc. WellCare Health Insurance of Illinois,
More informationIntro Who should read this document 2 Key Messages 2 Background 2
Classification: Policy Lead Author: Nathan Griffiths, Consultant Nurse Paediatric Emergency Medicine Additional author(s): N/A Authors Division: Salford Healthcare Unique ID: DDCPan04(14) Issue number:
More informationCardiac Rehabilitation
Cardiac Rehabilitation Introduction Experiencing heart disease should be the beginning of a new, healthier lifestyle. Cardiac rehabilitation helps you in two ways. First, it helps your heart recover through
More informationACLS Provider Manual Comparison Sheet Based on 2010 AHA Guidelines for CPR and ECC. BLS Changes
ACLS Provider Manual Comparison Sheet Based on 2010 AHA Guidelines for CPR and ECC CPR Chest compressions, Airway, Breathing (C-A-B) BLS Changes New Old Rationale New science indicates the following order:
More informationEmergency Cardiac Care: Decision Support Tool #3 RN-Initiated Treatment of Chest Pain or Discomfort Suggestive of Acute Coronary Syndrome
Emergency Cardiac Care: Decision Support Tool #3 RN-Initiated Treatment of Chest Pain or Discomfort Suggestive of Acute Coronary Syndrome Decision support tools are evidence based documents used to guide
More informationOxygen Therapy. Oxygen therapy quick guide V3 July 2012.
PRESENTATION Oxygen (O 2 ) is a gas provided in a compressed form in a cylinder. It is also available in a liquid form. It is fed via a regulator and flow meter to the patient by means of plastic tubing
More informationTarget groups: Paramedics, nurses, respiratory therapists, physicians, and others who manage respiratory emergencies.
Overview Estimated scenario time: 10 15 minutes Estimated debriefing time: 10 minutes Target groups: Paramedics, nurses, respiratory therapists, physicians, and others who manage respiratory emergencies.
More informationModule Two: EMS Systems. Wisconsin EMS Medical Director s Course
: EMS Systems Wisconsin EMS Medical Director s Course Objectives List the components of EMS systems Outline organizational and design options for EMS systems Outline system staffing and response configurations
More information12 Lead ECGs: Ischemia, Injury & Infarction Part 2
12 Lead ECGs: Ischemia, Injury & Infarction Part 2 McHenry Western Lake County EMS Localization: Left Coronary Artery Right Coronary Artery Right Ventricle Septal Wall Anterior Descending Artery Left Main
More informationUnderstanding and Preparing for a CAtHeteRIZAtIon PRoCeDURe
Understanding and Preparing for a CAtHeteRIZAtIon PRoCeDURe The Massachusetts General Hospital Heart Center and Vascular Center welcome you to the Knight Center for Interventional Cardiovascular Therapy.
More informationYour Guide to Express Critical Illness Insurance Definitions
Your Guide to Express Critical Illness Insurance Definitions Your Guide to EXPRESS Critical Illness Insurance Definitions This guide to critical illness definitions will help you understand the illnesses
More informationINTERFACILITY TRANSFERS
POLICY NO: 7013 PAGE 1 OF 8 EFFECTIVE DATE: 07-01-06 REVISED DATE: 03-15-12 APPROVED: Bryan Cleaver EMS Administrator Dr. Mark Luoto EMS Medical Director AUTHORITY: Health and Safety Code, Section 1798.172,
More informationDISCLOSURES RISK ASSESSMENT. Stroke and Heart Disease -Is there a Link Beyond Risk Factors? Daniel Lackland, MD
STROKE AND HEART DISEASE IS THERE A LINK BEYOND RISK FACTORS? D AN IE L T. L AC K L AN D DISCLOSURES Member of NHLBI Risk Assessment Workgroup RISK ASSESSMENT Count major risk factors For patients with
More informationACLS Study Guide BLS Overview CAB
ACLS Study Guide The ACLS Provider exam is 50-mutiple choice questions. Passing score is 84%. Student may miss 8 questions. For students taking ACLS for the first time or renewing students with a current
More information