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untilCardiovascular disease (CVD) is one of the leading causes of morbidity, disability and mortality in England and a significant driver of health inequalities. It disproportionately affects people in deprived and ethnic minority communities and accounts for one-fifth of the gap in life expectancy between most and least deprived areas. The King’s Fund report, Cardiovascular disease in England, highlights the need to prevent and manage CVD. CVD accounts for one in four of all deaths in England. The yearly health care costs related to CVD are estimated at £7.4 billion with an annual cost to the wider economy of £15.8 billion. At a time when the NHS and social care workforce and finances are facing unprecedented and rising pressures, urgent comprehensive action across the public health, health and care sectors is needed to significantly reduce the adverse health impacts of CVD and associated workloads and costs. Leaders and experts from across the NHS and its partners will gather to discuss how best to prioritise and deliver services to reduce the prevalence of CVD and its risk factors across the population, and to improve early detection, management and treatment of CVD and its risk factors. Register -
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Patients in England are set to benefit from a radical new project that will look to identify innovative new methods of preventing cardiovascular disease, as the Department of Health and Social Care appoints the first ever Government Champion for Personalised Prevention. John Deanfield CBE, a Professor of Cardiology at University College London, has been asked by the health secretary to explore how the potential of technology and data can be properly harnessed to allow people to better look after their health and reduce the risk of cardiovascular disease. Professor Deanfield will spearhead a taskforce comprised of experts in everything from policy and technology to economics and behavioural science to deliver a range of recommendations that will lay the foundations for a modern, tailored cardiovascular disease prevention service. The Government say the recommendations will: Identify breakthroughs in predicting, preventing, diagnosing and treating risk factors for cardiovascular disease. Advise on how public services, businesses and the population can be encouraged to support prevention outside the NHS. Use personalised data to predict and manage disease more effectively. Bring care closer to homes and communities by establishing new partnerships that advance the way preventative services are delivered. Evaluate how this strategy for cardiovascular disease prevention may impact conditions with shared risk factors. Read full story Source: NHE, 7 March 2023- Posted
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Inappropriate anticoagulation of patients with a mechanical heart valve
Patient-Safety-Learning posted a news article in News
NHS England have issued a safety alert on the risk of inappropriate anticoagulation of patients with a mechanical heart valve. Published guidance supported clinical teams in reviewing patients being treated with a vitamin K antagonist (VKA) early on in the pandemic and change their medication to an alternative anticoagulant where needed. However, there have been reports that those with a mechanical heart valve have been prescribed a molecular weight heparin (LMWH) or a direct oral anticoagulant (DOAC) which the guidance lists as an exception to its use in such patients. The alert asks GPs and other NHS providers to urgently identify patients with a mechanical heart valve and ensure they are on the most appropriate anticoagulant. Read full story. Source: NHS England, 14 July 2021 -
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Wearable fitness trackers could interfere with cardiac devices, study finds
Patient Safety Learning posted a news article in News
Wearable fitness and wellness trackers could interfere with some implanted cardiac devices such as pacemakers, according to a study. Devices such as smartwatches, smart rings and smart scales used to monitor fitness-related activities could interfere with the functioning of cardiac implantable electronic devices (CIEDs) such as pacemakers, implantable cardioverter defibrillators (ICDs), and cardiac resynchronisation therapy (CRT) devices, the study published in the Heart Rhythm journal found. Researchers found that the electrical current used in wearable smart gadgets during “bioimpedance sensing” interfered with proper functioning of some implanted cardiac devices from three leading manufacturers. Lead researcher, Dr Benjamin Sanchez Terrones, of the University of Utah. said the results did not convey any immediate or clear risks to patients who wear the trackers. However, the different levels of electrical current emitted by the wearable devices could result in pacing interruptions or unnecessary shocks to the heart. Further research was needed to determine the actual level of risk". “Our research is the first to study devices that employ bioimpedance-sensing technology as well as discover potential interference problems with CIEDs such as CRT devices. We need to test across a broader cohort of devices and in patients with these devices. Collaborative investigation between researchers and industry would be helpful for keeping patients safe,” Sanchez said. Read full story Source: The Guardian, 22 February 2023- Posted
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Understanding Covid-19 as a vascular disease and its implications for exercise
Anonymous posted an article in Blogs
Since the beginning of the Covid-19 pandemic, we have known that the virus can affect the heart and cardiovascular system.[1] Covid is not primarily a respiratory disorder, it is a disease of the blood vessels. Recent statistics also suggest there has been an increase in excess deaths due to cardiovascular causes since the end of lockdown measures—but these deaths are not being linked to Covid-19 in official data. This area needs further research so that we can better understand the ways in which Covid is causing morbidity and mortality in the wider population. Research shows the link between Covid and cardiac events There have been many personal accounts of otherwise healthy people experiencing ongoing cardiac symptoms [2] due to Covid-19 infection. Now, over two years into the pandemic, we have significant research evidence establishing the link between Covid-19 and cardiovascular disease.[3] Multiple studies highlight an increased risk of stroke and heart attack after Covid,[4][5] and many show that the virus causes new onset cardiovascular issues in previously healthy individuals. Thrombosis and embolism can occur up to a year after infection,[4][7][8] even in people in their twenties, leading to significantly increased rates of cardiac events, angina, strokes and blockage of arteries to limbs. Despite this growing body of evidence, awareness is low among the public and the medical community that Covid-19 is a vascular disease. This means that patients are not always being assessed for potential heart problems, as they should be, when seeing a doctor or attending A&E with chest pain, palpitations or shortness of breath. Patients are being misinformed because of gaps in doctors’ knowledge As a result of this knowledge gap, there are also concerns that patients are being given inappropriate advice about exercise during and in the weeks following a Covid infection. Exercising with the virus can lead to cardiovascular issues developing or worsening, sometimes with devastating consequences. In addition to research about cardiovascular disease and Covid, we have a wealth of knowledge about exercise and myocarditis from sport scientists who have been studying cardiovascular disease in athletes for decades. A US study carried out in 2021 highlights that, “Emerging observational data coupled with widely publicized reports of athletes in competitive sports with reported Covid-19–associated cardiac pathology suggest that myocardial injury may occur in cases of Covid-19 that are asymptomatic and of mild severity.”[9] While the rates of cardiac involvement in athletes after Covid have been low, it is important to take a cautious approach. There is currently a lack of consistency in the advice patients are given about exercise and Covid, both in the acute stage of infection and afterwards in patients that develop Long Covid. Some people report having been actively advised by healthcare professionals to exercise following a recent Covid-19 infection, but this advice goes against what research tells us: As with any viral infection, exercising with an acute Covid infection, even if it is asymptomatic, increases the small risk of developing myocarditis—inflammation of the heart. If it occurs, myocarditis can cause sudden unexplained death in a small proportion of otherwise healthy adults. People with confirmed myocarditis should not undertake significant exertion for 3-6 months as there is a small but significant risk of sudden death.[10] Promoting a safe approach to Covid, work and exercise Part of the issue is the lack of guidance for GPs and other doctors dealing with both acute Covid patients and those with Long Covid. A rapid guideline on Managing the long term effects of COVID-19 published by the National Institute for Health and Care Excellence (NICE) in March 2022 stated that “in the absence of evidence relating to people with ongoing symptoms from Covid-19 [the panel] could not make specific recommendations,” although it also asserted that “the panel considered careful self-pacing of exercise to be an important element of self-management.”[11] But we now know enough to be able to provide some clear principles around safe exercise related to both acute Covid-19 infection and Long Covid. The World Health Organization living guideline on rehabilitation in Post Covid Condition recommends that in adults with Long Covid, “exertional desaturation and cardiac impairment following Covid-19 should be ruled out and managed before consideration of physical exercise training… Red flags for safe rehabilitation are those complications where commencing rehabilitation could cause an acute event or deterioration.”[12] World Physiotherapy also urges caution when it comes to exercise. In its briefing paper on safe rehabilitation in Long Covid, it states that, “It is critical to establish the reason or source of chest pain, dyspnoea, tachycardia, or hypoxia, to prevent harm and appropriately guide physical activity including exercise.”[13] It highlights that before physical activity is used as a rehabilitation intervention for people living with Long Covid, individuals should be screened for: post-exertional symptom exacerbation cardiac impairment exertional oxygen desaturation autonomic dysfunction and orthostatic intolerances.[13] Here are the key messages about Covid and safe exercise that we need to be getting across as widely as possible. Key messages for healthcare professionals The basic problem in Covid-19 is thrombotic vasculitis (inflammation of blood vessels) which leads to increased rates of serious cardiac and vascular complications in people of any age. Healthcare staff in accident and emergency, hospital medicine and general practice should know that cardiac complications of Covid-19 (angina, acute coronary events, arrhythmias and myocarditis) occur commonly after initial infection, even in young people, and can be present for a prolonged period after infection. Emergency department staff must be aware that myocarditis may occur during acute Covid-19, often caused directly by the virus, or in the weeks and months after infection, which is likely to be caused by an immune-mediated reaction.[14] Blood tests, including Troponin T and BNP should be taken, an ECG carried out and an urgent cardiac MRI should be arranged.[15] Key messages for the public and employers As with any viral infection, if you have Covid-19 you should rest during the first days of infection, when symptomatic. You should then follow a gradual approach to exertion following infection as recommended by the Faculty of Sport and Exercise Medicine UK’s Graduated Return to Play guidance following Covid-19 infection. It can be helpful to use a wearable tech device such as a heart rate and heart rate variability watch. You should also go by how you feel and not push through fatigue. If you have new and persistent chest pain in the days, weeks and months after Covid-19, you should not be undertaking exercise until you have had it investigated by a doctor. This advice also needs to be applied to returning to physically strenuous work following Covid; it’s vital to consider the cardiovascular aspects of Covid before staff can return to ‘heavy work’. To provide clear guidance for employers, the Society of Occupational Medicine recently published a position paper on Long Covid and return to work. The paper pulls together current evidence on how to return to work safely and sustainably after Covid-19. It collates practices from occupational health services around the world, and a range of medical specialists contributed lists of investigations, red flags and reasons for referral, and guidance on best practice for activity. A key theme through the document is the need for early intervention to prevent cardiovascular damage. Although exercise and exertion are part of many people’s daily routine, just pushing through Covid and Long Covid symptoms to maintain your routine is a dangerous approach. It’s better to miss your jog for a few weeks than risk long-term damage to your cardiovascular system. References 1 Eunjung Cha A. Young and middle-aged people, barely sick with covid-19, are dying of strokes. Washington Post, 25 April 2020 2 Dolgin E. COVID’s cardiac connection. Nature. 9 June 2021 3 Part 3: Graham Lloyd-Jones, The anatomy of COVID-19. Oro-Systemic Health Symposium 2022. 12 April 2022 4 Xie Y, Xu E, Bowe B et al. Long-term Cardiovascular Outcomes of COVID-19. Nature Medicine. 2022:28;583-90 5 Al-Aly Z, Bowe B, Xie Y. Outcomes of SARS-CoV2 Reinfection (preprint). 17 June 2022 6 Basu-Ray I, Almaddah N, Adeboye A et al. Cardiac Manifestations Of Coronavirus (COVID-19). StatPearls. 2 May 2022 7 Katsoularis I, Fonseca-Rodríguez O, Farrington P et al. Risks of deep vein thrombosis, pulmonary embolism, and bleeding after COVID-19: nationwide self-controlled cases series and matched cohort study. BMJ. 6 April 2022 8 Raman B, Bluemke DA, Lüscher TF et al. Long COVID: post-acute sequelae of COVID-19 with a cardiovascular focus. Eur Heart J. 2022:43(11);1157–72 9 Kim JH , Levine BD , Phelan D , et al. Coronavirus disease 2019 and the athletic heart: emerging perspectives on pathology, risks, and return to play. JAMA Cardiol. 2021:6;219–27 10 Salman D, Vishnubala D, Le Feuvre P, Beaney T, Korgaonkar J, Majeed A, et al. Returning to physical activity after COVID-19. BMJ. 8 January 2021 11 National Institute for Health and Care Excellence. COVID-19 rapid guideline: managing the long-term effects of COVID-19. 1 March 2022 12 World Health Organization. Clinical management of COVID-19: Living guideline, 15 September 2022 13 World Physiotherapy. Briefing paper 9 - Safe rehabilitation approaches for people living with Long Covid: Physical activity and exercise, 14 July 2021 14 Raman B, Bluemke DA, Lüscher TF et al. Long COVID: post-acute sequelae of COVID-19 with a cardiovascular focus. Eur Heart J. 2022:43(11);1157–72 15 Lampejo T, Durkin SM, Bhatt N, Guttmann O. Acute myocarditis: aetiology, diagnosis and management. Clinical Medicine. 2021:21(5);e505–10- Posted
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Key points CVD is largely preventable. The risk factors for CVD apply also to other major conditions such as cancer, dementia and diabetes. Preventing and managing CVD and its risk factors therefore has the potential to improve population health, reduce health inequalities and ease pressures on overstretched health and care systems by reducing demand for services. The current national CVD policy landscape is fragmented. National leaders need urgently to deliver coherent CVD and public health strategies that focus on preventing and managing CVD and its risk factors. Given its high prevalence and large contribution to health inequalities, tackling CVD will be a relevant priority in most local areas. Integrated care systems (ICSs) can tackle CVD in their local areas by establishing strong local leadership and partnerships on CVD and public health, focusing on preventing and managing CVD and its risk factors, raising awareness of CVD, using data, tools and technology effectively, and reducing clinical variation.- Posted
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Covid: Half a million people missed out on heart drugs
Patient Safety Learning posted a news article in News
During the pandemic, nearly half a million people in the UK missed out on starting medication to help prevent heart attacks and strokes, a new study suggests. The British Heart Foundation (BHF) team looked at prescribing data for the first 18 months after Covid hit. Some 491,000 people (27,000 a month) appear to have missed out on blood pressure pills, and 316,000 did not get treatment to lower their cholesterol. The team says more needs to be done to make sure that anyone who needs treatment gets it. During the pandemic, normal NHS services were severely disrupted. For example, there was a reduction in diagnosis, monitoring and treatment of high blood pressure, and other heart and circulation disease risk factors. Although the NHS took action, including providing more than 220,000 blood pressure monitors for people to use at home, data shows two million fewer people in England were recorded as having controlled hypertension in 2021 compared to the previous year. Lead investigator Prof Reecha Sofat, who is based at the University of Liverpool, said the findings, published in the journal Nature Medicine, highlight the impact Covid has had on other important health conditions: "Despite the incredible work done by NHS staff, our data show that we're still not identifying people with cardiovascular risk factors at the same rate as we were before the pandemic. " Read full story Source: BBC News, 20 January 2023- Posted
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What is an Adjournment Debate? There is a 30 minute Adjournment Debate at the end of each day's sitting of the House of Commons. They provide an opportunity for an individual backbench MP to raise an issue and receive a response from the relevant Minister. Unlike many other debates, these take place without a question which the House of Commons must then make a decision on. Diagnosis of pulmonary embolisms In this debate Helen Hayes, MP for Dulwich and West Norwood, outlined significant patient safety issues relating to misdiagnosis of pulmonary embolisms. She highlighted concerns raised by her constituent, Tim Edwards, relating to the premature death of his mother Jenny. His research has estimated that there was a minimum of 400 excess pulmonary embolism deaths across England from April 2021 to March 2022, and that that excess figure is attributable to cases that were missed. She asked the Minister to agree to work with NHS England to commission a review of the data set out in a forthcoming report from Tim Edwards and the related concerns raised by the Royal College of Radiologists, with a view to ensuring that the rate of misdiagnosis of pulmonary embolism is greatly reduced.- Posted
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NHS disruption driving rise in heart deaths, charity says
Patient Safety Learning posted a news article in News
Extreme disruption to NHS services has been driving a sharp spike in heart disease deaths since the start of the pandemic, a charity has warned. The British Heart Foundation (BHF) said ambulance delays, inaccessible care and waits for surgery are linked to 30,000 excess cardiac deaths in England. It has called for a new strategy to reduce "unacceptable" waiting times. Doctors and groups representing patients have become increasingly concerned about the high number of deaths of any cause recorded this year. New analysis of the mortality data by the BHF suggests heart disease is among the most common causes, responsible for 230 deaths a week above expected rates since February 2020. The charity said "significant and widespread" disruption to heart care services was driving the increase. Its analysis of NHS data showed that 346,129 people were waiting for time-sensitive cardiac care at the end of August 2022, up 49% since February 2020. It said 7,467 patients had been waiting more than a year for a heart procedure - 267 times higher than before the pandemic. At the same time, the average ambulance response time for a suspected heart attack has risen to 48 minutes in England against a target of 18 minutes, according to the latest NHS figures. The BHF said difficulty accessing face-to-face GP and hospital care may have also contributed to the rise. Read full story Source: BBC News, 3 November 2022- Posted
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Heart attack responses a ‘shambles’ as patients face eight-hour ambulance waits
Patient Safety Learning posted a news article in News
Senior doctors have sent a warning over the “shambles” of heart attack care after pressures on the NHS have left patients waiting eight hours for an ambulance. The caution comes as several hospitals in the past week have declared critical incidents over the level of pressure on their emergency care services. Portsmouth Hospital said on Monday: “Demand for an emergency response is far outstripping the capacity available in Portsmouth and South East Hampshire at this time.” Professor Mama Mamas, a consultant cardiologist in Stoke and Professor of Cardiology at Keele University, told The Independent: “I was on call this weekend and I was seeing delays of eight hours. It was several people, three or four this weekend with heart attacks that waited between four and eight hours … it’s a national disgrace that we’re in this situation. “I think that patient care is being compromised. We know that time is muscle and an eight-hour delay getting an ambulance to a patient with a heart attack is impacting on the survival levels.” Read full story Source: The Independent, 13 October 2022- Posted
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During a cardiac ablation procedure, the catheter irrigation fluid bag emptied and was replaced by staff. While priming the tubing, air was noted in the tube, and the catheter was immediately removed from the patient. The patient experienced a decrease of heart rate and blood pressure requiring a code response. Radiofrequency cardiac ablation requires the use of heparinised irrigation fluid to cool and anticoagulate the ablation site. If the procedure requires more fluid than originally hung, it requires the bag to be replaced. This introduces an opportunity for air to enter the irrigation tubing. Air emboli can then be infused into the patient causing cardiac arrhythmia, myocardial infarction, respiratory symptoms and/or neurologic symptoms, and, potentially, total cardiovascular collapse. Solutions During cardiac ablation procedures, air should be removed from any bags and the pump (or any other pressurized delivery device) tubing primed before being connected to a patient. Do not bypass alarms that detect air in the pump or tubing systems. Do not prime the irrigation line without first disconnecting the tubing set from the patient, even if a stopcock is in use. Review the manufacturer’s instructions for how to change fluid bags to ensure safe operations. Be aware of potential access points for air to enter the system and mitigate the risk.- Posted
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Remote monitoring service to be expanded in Norfolk following success
Patient Safety Learning posted a news article in News
Norfolk Community Health and Care it is using a remote monitoring service from Inhealthcare which allows patients to monitor their vital signs at home and relay readings via a choice of communication channels to clinicians who monitor trends and intervene if readings provide any cause for concern. Analysis of the six months before and after introduction showed a significant reduction in hospital bed days, A&E attendances, GP visits and out-of-hours appointments. Lead heart failure nurse at the trust, Rhona Macpherson, spoke to Digital Health News about the impact of the services on patients and nurses. For Macpherson, the service has helped promote self-management. “We give each of the patients a set of scales, blood pressure monitor and pulse oximeter and we get them to do their observations,” she said. “So we’re promoting self-management and looking at things but also it means that we can get accurate information on what’s happening with their observations. “We then set parameters to alert if they go outside of the parameters, and it just means we can intervene much more quickly than we would do, and we can see what’s going on between our visits as well as what’s happening when we’re actually there.” The service has transformed working practices for nurses, increasing efficiency and saving valuable time. Macpherson said: “We’re using the technology to try and make ourselves a little bit more efficient, so it’s saving on the travel time and face to face visits. “We can do a lot more with telephone. We’ve got the option of using video, but telephone is actually quite useful. So it’s less face to face visits, less travel and also, we’re trying to empower the patients to do their own observations and monitor themselves, rather than us just doing it for them.” -
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untilCardiovascular disease (CVD) is one of the leading causes of morbidity, disability and mortality in England and a significant driver of health inequalities. It disproportionately affects people in deprived and ethnic minority communities and accounts for one-fifth of the gap in life expectancy between most and least deprived areas. The NHS Long Term Plan (2019) highlights the need to prevent and manage CVD. CVD accounts for one in four of all deaths in England. The yearly health care costs related to CVD are estimated at £7.4 billion with an annual cost to the wider economy of £15.8 billion. At a time when NHS and social care workforce and finances are overstretched, urgent comprehensive action across the public health, health and care sectors is needed to significantly reduce the adverse health impacts of CVD and associated workloads and costs. Leaders and experts from across the NHS and its partners will gather to discuss how best to prioritise and deliver services to reduce the prevalence of CVD and its risk factors across the population, and to improve early detection, management and treatment of CVD and its risk factors. Register -
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AI eye checks can predict heart disease risk in less than minute, finds study
Patient Safety Learning posted a news article in News
An artificial intelligence (AI) tool that scans eyes can accurately predict a person’s risk of heart disease in less than a minute, researchers say. The breakthrough could enable ophthalmologists and other health workers to carry out cardiovascular screening on the high street using a camera – without the need for blood tests or blood pressure checks – according to the world’s largest study of its kind. Researchers found AI-enabled imaging of the retina’s veins and arteries can specify the risk of cardiovascular disease, cardiovascular death and stroke. They say the results could open the door to a highly effective, non-invasive test becoming available for people at medium to high risk of heart disease that does not have to be done in a clinic. “This AI tool could let someone know in 60 seconds or less their level of risk,” the lead author of the study, Prof Alicja Rudnicka, told the Guardian. If someone learned their risk was higher than expected, they could be prescribed statins or offered another intervention, she said. Speaking from a health conference in Copenhagen, Rudnicka, a professor of statistical epidemiology at St George’s, University of London, added: “It could end up improving cardiovascular health and save lives.” Read full story Source: The Guardian, 4 October 2022 -
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Key findings Bystander Cardiopulmonary Resuscitation (CPR) Ongoing strategies are needed at a population level to ensure that people who sustain an OHCA are treated rapidly with high quality resuscitation, including defibrillation, through a co-ordinated network of accessible and identifiable public access devices. Advance treatment plans When advance treatment plans are in place, they should be documented using a standard process (such as the ReSPECT form) to ensure that people receive treatments based on what matters to them and what is realistic. Effective communication between all parts of the healthcare system, including, primary care, community services, ambulance services and acute hospitals is then needed to ensure that appropriate decisions are made, irrespective of time or location. Prediction of survival No single factor is accurate enough for clinical decision-making at the time of admission to hospital following an OHCA. Time is needed to ensure an accurate assessment of prognosis can be made. Neurological prognosis is particularly difficult to assess, and this should be delayed for at least 72 hours after return of spontaneous circulation. Targeted temperature management Elevated temperature is common following an OHCA and is associated with a worse prognosis, but this can be improved by accurate, active temperature control. The current approach in clinical practice appears to be inconsistent and a more active approach is needed. Rehabilitation Physical, neurological, cardiac and emotional impairment following an OHCA can all affect quality of survival, and patients benefit from targeted rehabilitation and support. In some areas of the UK there is no provision of these services. These gaps should be closed by local clinical teams and commissioners working together.- Posted
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Key findings One delay or more in the process of care was identified in 161/420 (38.3%) patients, with recognition, investigations and treatment being the most common. The primary treatment for PE is anticoagulation. It is imperative that this is started as soon as possible. Where there might be a delay to the diagnosis of acute PE anticoagulation should be commenced. In this study the case reviewers reported an avoidable delay in commencing treatment in 90/481 (18.7%) patients. Once PE has been diagnosed an assessment of PE severity needs to be undertaken in order to treat patients effectively. In 144/179 (80.4%) hospitals their PE policy/guideline included the assessment of PE severity. This severity assessment was based on a validated scoring system such as PESI or Hestia in 128/142 (90.1%) hospitals. Case reviewers found no evidence of a PE severity assessment in the majority of patients (436/483; 90.3%). Severe (massive) PE requires additional or alternative treatment. A guideline/protocol for the diagnosis and care of patients with PE was provided at 151/180 (83.9%) hospitals. Ambulatory care has recently become a recognised pathway for PE management in those patients with low-risk of adverse outcomes. An ambulatory care pathway was used for all or part of the patient journey in 77/474 (16.2%) patients in this study. Wide variation in the selection of patients for ambulatory care was observed, with some high-risk patients being selected on this pathway and low-risk patients not being considered for it, resulting in unnecessary hospital admissions. Patients should receive all the information they need to make an informed choice, particularly with respect to taking anticoagulation. Treating clinicians were unable to determine if the patient was given verbal or written information regarding PE in 336/600 (56.0%) instances and specific information/ education regarding PE was not routinely provided to patients at 55/167 (32.9%) hospitals. An outpatient follow-up was not routinely arranged following a PE diagnosis in 32/179 (17.9%) hospitals.- Posted
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One in 25 heart attack deaths in north-east of England ‘preventable in London’
Patient Safety Learning posted a news article in News
One in 25 people who die of a heart attack in the north-east of England could have survived if the average cardiologist effectiveness was raised to the London level, research shows. The research, undertaken by the Institute for Fiscal Studies (IFS), looked at the record of over 500,000 NHS patients in the UK, over 13 years. It highlights the stark “postcode lottery” of how people living in some parts of the country have access to lower quality healthcare. The results found that while cardiologists treating patients in London and the south-east had the best survival rates among heart attack patients, patients being treated in the north-east and east of England had the worst. Among 100 otherwise identical patients, an additional six patients living in the north-east and east of England would have survived for at least a year if they had instead been treated by a similar doctor in London. Furthermore, if the effectiveness of doctors treating heart attacks in these areas of the country were just as effective as the cardiologists in London, an additional 80 people a year in each region would survive a heart attack. The research also revealed a divide between rural and urban areas of England, with patients living in the former typically receiving treatment from less effective doctors compared with those in more urban areas. Read full story Source: The Guardian, 9 August 2022- Posted
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Making a decision about Dupuytren’s contracture Making a decision about carpal tunnel syndrome Making a decision about hip osteoarthritis Making a decision about knee osteoarthritis Making a decision about further treatment for atrial fibrillation Making a decision about cataracts Making a decision about glaucoma Making a decision about wet age-related macular degeneration- Posted
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untilCardiovascular disease (CVD) is the leading cause of death in the UK, yet is largely preventable. It is the single biggest area where the NHS can save lives over the next decade, and as such, is a core priority in the NHS Long Term Plan. With the onset of the COVID-19 pandemic, came an acceleration in adoption of technology as a tool within the NHS - both in clinic and in community - to enhance patient outcomes and professional pathways. These available technologies have a significant role to play, both broadly in alignment with the NHS LTP and also more specifically in the quest to close the atrial fibrillation detection gap. This webinar will highlight the technologies available to the NHS for ambulatory monitoring of CVD and also showcase recent NICE recommendation of the first and only personal ECG to achieve such status. Speaking on this topic will be Trudie Lobban, CEO and Founder of the Arrhythmia Alliance, and Dr Matt Reed, Consultant in Emergency Medicine, Edinburgh. Register -
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What do these findings mean? Acute COVID-19 is associated with increased risk of cardiovascular disorders, but risk generally returns to background levels soon after the infection. The risk of new DM remains increased for at least 12 weeks following COVID-19 before declining. Patients recovering from COVID-19 should be advised to consider measures to reduce diabetes risk including healthy diet and taking exercise. People without preexisting CVD or DM who suffer from COVID-19 do not appear to have a long-term increase in incidence of these conditions. -
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