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Showing results for tags 'Medicine - Cardiology'.
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News Article
'Tens of thousands' of heart procedures delayed by pandemic
Patient Safety Learning posted a news article in News
The postponement of tens of thousands of hospital procedures is putting the lives of people with long-term heart conditions at risk, according to the British Heart Foundation. The coronavirus pandemic has created a backlog which would only get larger as patients waited for care, it said. People with heart disease are at increased risk of serious illness with COVID-19, and some are shielding. The BHF estimates that 28,000 procedures have been delayed in England since the outbreak of coronavirus in the UK. These are planned hospital procedures, including the implanting of pacemakers or stents, widening blocked arteries to the heart, and tests to diagnose heart problems. People now waiting for new appointments would already have been waiting for treatment when the lockdown started, the charity said, as it urged the NHS to support people with heart conditions "in a safe way". Read full story Source: 5 June 2020 -
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News Article
Warning as UK coronavirus outbreak leads to sharp rise in deaths at home
Patient Safety Learning posted a news article in News
The coronavirus crisis has led to a sharp rise in the number of seriously ill people dying at home because they are reluctant to call for an ambulance, doctors and paramedics have warned. Minutes of a remote meeting held by London A&E chiefs last week obtained by the Guardian reveal that dozens more people than usual are dying at home of a cardiac arrest – potentially related to coronavirus – each day before ambulance crews can reach them. And as the chair of the Royal College of GPs said that doctors were noticing a spike in the number of people dying at home, paramedics across the country said in interviews that they were attending more calls where patients were dead when they arrived. The minutes also reveal acute concern among senior medics that seriously ill patients are not going to A&E or dialling 999 because they are afraid or do not wish to be a burden. “People don’t want to go near hospital,” the document said. “As a result salvageable conditions are not being treated.” Read full story Source: The Guardian, 16 April 2020 -
News Article
Covid-19: Doctors are told not to perform CPR on patients in cardiac arrest
Patient Safety Learning posted a news article in News
Healthcare staff in the West Midlands have been told not to start chest compressions or ventilation in patients who are in cardiac arrest if they have suspected or diagnosed covid-19 unless they are in the emergency department and staff are wearing full personal protective equipment (PPE). The guidance from the University Hospitals Birmingham NHS Foundation Trust says that patients in cardiac arrest outside the emergency department can be given defibrillator treatment if they have a “shockable” rhythm. But if this fails to restart the heart “further resuscitation is futile,” it says. If a patient with suspected covid-19 is in cardiac arrest they should be given cardiac compressions and be ventilated only if they are in the emergency department and the person attending them is wearing aerosol generating procedures (AGP) PPE. That means wearing an FFP3 mask, full gown with long sleeves, gloves, and eye protection. The advice rests on the premise that performing cardiac compressions risks virus particles being released into the air that could infect staff. Read full story Source: BMJ, 29 March 2020- Posted
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Aerosol generating procedures, Covid-19 and cardiopulmonary resuscitation
Ken Spearpoint posted an article in Blogs
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News Article
Machine 'could quadruple' heart and lung transplants
Patient Safety Learning posted a news article in News
The number of heart and lung transplants could quadruple thanks to a "reanimation" machine used in a pioneering operation, a hospital says. The device, developed at Royal Papworth Hospital in Cambridge, managed to pump oxygenated blood into both organs in a world-first procedure. The machine can revitalise deteriorating organs allowing "donation after circulatory death" (DCD). Hospital surgeon Pedro Catarino said it was like "recharging the batteries". "It is reanimation and then it replenishes the energy stores of the heart, what we call reconditioning, which allows it be transplanted," he said. "We think it could at least double and perhaps quadruple the number of [heart and lungs] available for transplant." He said it was desperately needed, adding: "Patients die on the waiting list every day." Read full story Source: BBC News, 23 March 2020 -
News ArticleMedStar Health launched a new tool that automatically calculates a patient's risk of having a heart attack or stroke within 10 years. The tool enables doctors to more easily show patients their personal risk for heart disease, stroke and other cardiovascular diseases over time using easy-to-read graphics. "Seeing their risk on a visual display is more powerful than me telling them their risk,” said Ankit Shah, Director, Sports and Performance Cardiology for the MedStar Heart & Vascular Institute at Union Memorial Hospital in Baltimore. The tool is embedded in MedStar's Cerner electronic health record (EHR), making it easier for physicians to use it during patient visits, health system officials said. The project highlights how MedStar Health National Center for Human Factors focuses on human factor design to improve technology for patients as well as providers. Final rules from the US Department of Health and Human Services (HHS) will make it easier in the future for patients to share their health data with third-party apps. Read full story Source: FierceHealthcare, 9 March 2020
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News Article
Distance not always factor in ambulance response times
Patient Safety Learning posted a news article in News
There is significant variation in ambulance response times to patients with serious conditions such as suspected strokes or heart attacks, which is not fully explained by how rural an area is, an HSJ analysis has revealed. The exclusive analysis represents the first time ambulance performance for category two calls, which have an 18-minute response time target, have been broken down to clinical commissioning group level. Category two, known as emergency calls, covers a wide range of conditions, including suspected stroke and heart attacks (except cardiac arrests), major burns and epileptic seizures. They account for well over half of ambulance responses. The findings — described as “alarming” by the Stroke Association — lay bare the incredibly long waits which are usually hidden, because average waiting time data is usually published for ambulance trusts, which cover far larger areas than CCGs. Mark MacDonald, Deputy Director of Policy at the Stroke Association, said: “It is alarming to hear that in some cases ambulance staff are taking over an hour to reach patients because when it comes to stroke, being assessed quickly and then, if necessary, transferred to hospital, is really important.” Read full story (paywalled) Source: HSJ, 5 March 2020 -
Content Article
Capnography: No Trace = Wrong Place
Patient Safety Learning posted an article in High risk areas
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News Article
Earlier recognition of aortic dissection needed to prevent deaths
Patient Safety Learning posted a news article in News
Up to half of all patients who suffer an acute aortic dissection may die before reaching crucial specialist care, according to a new Healthcare Safety Investigation Branch (HSIB) report. The report highlights the difficulty which can face hospital staff in recognising acute aortic dissection. The investigation was triggered by the case of Richard, a fit and healthy 54-year old man, who arrived at his local emergency department by ambulance after experiencing chest pain and nausea during exercise. It took four hours before the diagnosis of an acute aortic dissection was made, and he spent a further hour waiting for the results of a CT scan. Although Richard was then transferred urgently by ambulance to the nearest specialist care centre, he sadly died during the journey. The report has identified a number of risks in the diagnostic process which might result in the condition being missed. These include aortic dissection not being suspected because patients can initially appear quite well or because symptoms might be attributed to a heart or lung condition. It also highlighted that, once the diagnosis is suspected, an urgent CT scan is required to confirm that an acute aortic dissection is present. Gareth Owens, Chair of the national patient association Aortic Dissection Awareness UK & Ireland, welcomed the publication of HSIB’s report, saying: “HSIB’s investigation and report have highlighted that timely, accurate recognition of acute Aortic Dissection is a national patient safety issue. This is exactly what patients and bereaved relatives having been telling the NHS, Government and the Royal College of Emergency Medicine for several years." Read full story Source: HSIB, 23 January 2020 -
Content ArticleSafety recommendations HSIB have made two safety recommendations to help improve the recognition of acute aortic dissection: The first is to add ‘aortic pain’ to the list of possible presenting features included in the triage systems used to prioritise patients attending emergency departments. The second recommends the development of an effective national process to help staff in emergency departments detect and manage this condition.
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Surgeons withdraw support for heart disease advice
Patient Safety Learning posted a news article in News
European clinical guidelines on how to treat a major form of heart disease are under review following a BBC Newsnight investigation. Europe's professional body for heart surgeons has withdrawn support for the guidelines, saying it was "a matter of serious concern" that some patients may have had the wrong advice. Guidelines recommended both stents and heart surgery for low-risk patients, but trial data leaked to Newsnight raises doubts about this conclusion. Thousands of people in the UK and hundreds of thousands worldwide will be treated for left main coronary artery disease each year. This is a narrowing of one of the main arteries in the heart. The guidelines on how to treat it were largely based on a three-year trial to compare whether heart surgery or stents – a tiny tube inserted into a blocked blood vessel to keep it open – was more effective. The trial called Excel started in 2010 and was sponsored by big US stent maker, Abbott. Led by US doctor Gregg Stone, the study and aimed to recruit 2,000 patients. Half were given stents and the other half open heart surgery. Success of the treatments was measured by adding together the number of patients that had heart attacks, strokes, or had died. The research team used an unusual definition of a heart attack, but had said that they would also publish data for the more common "Universal" definition of a heart attack alongside it. There is debate around which is a better measure and the investigators stand by their choice. In 2016, the results of the trial for patients three years after their treatments were published in the New England Journal of Medicine. The article concluded stents and heart surgery were equally effective for people with left main coronary artery disease. But researchers had failed to publish data for the common, "Universal" definition of a heart attack. Newsnight has seen that unpublished data and it shows that under the universal definition, patients in the trial that had received stents had 80% more heart attacks than those who had open heart surgery. The lead researchers on the trial have told Newsnight that this is "fake information". But Newsnight has spoken to experts who say they believe the data is credible. Read full story Source: BBC News, 9 December 2019 -
Content Article
Remove central lines supine - animation (2017)
Claire Cox posted an article in Implementation of improvements
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Content ArticleFollowing a review of the events that led up to Amy’s death Great Ormond Street Hospital have already made changes to practice: They have improved the way clinical information is shared between different specialist teams, to make sure staff have as comprehensive a picture as possible when making complex decisions about a patient’s treatment. They now use a single log-in electronic patient record system which means staff can quickly access clinical information about a patient and have the right information at the right time, rather than routinely having to use multiple systems. They have improved consultant availability. This means there is more consultant time for each patient being looked after in our paediatric intensive care unit. They have introduced a new process to make sure the care of patients, like Amy, who have both complex spinal and heart conditions is routinely considered by the hospital’s specialist joint cardiology committee.
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Content ArticleKey learning points If the patient had been more closely observed it is likely cardio-respiratory arrest and subsequent hypoxic brain injury could have been avoided. Effective procedures for nurse communication, effective handover and observation of critically unwell patients in intensive care and high dependency units are very important to safe patient care. Bedside and remote monitoring equipment provide vital information to staff and should be properly maintained and replaced where necessary.
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AHSN: Using portable technology to detect and prevent strokes (October 2016)
Claire Cox posted an article in AHSNs
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Content ArticleWhat will I learn? This report sets out 17 recommendations to improve the way vascular surgery – surgery to repair and restore blood supply to organs and areas of the body – is delivered in the NHS in England. The recommendations focus primarily on the way vascular surgery is organised and delivered, with the central goal of enabling patients to receive urgent surgery sooner. Taken together, they could not only deliver better surgical outcomes for seriously ill patients but also reduce length of stay, cut readmission's and make better use of surgical resources. The report also recommends steps to improve the quality of data gathered around vascular surgery, as a precursor to further long-term change, and identifies opportunities to deliver substantial cost savings on procurement of devices and consumables.
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Content ArticleThe investigation set out to investigate the removal, retention, and disposal of human tissue and organs at Alder Hey Children’s hospital following hospital post-mortem examinations and, the extent to which the Human Tissue Act 1961 (HTA) had been complied with. It involved examination of the professional practice and management action and systems, including what information, if any, was given to the parents of deceased children relating to organ or tissue removal, retention and disposal.
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Content ArticleThe list of interventions is not exhaustive and reflects those tested in the third wave of the Elective Care Development Collaborative using the 100 day methodology. Specialties in this wave included cardiology, ENT and urology. Interventions are grouped by theme within this handbook and include ‘how-to’ guides. The success of interventions designed to transform local elective care services should be measured by changes in local activity following implementation of the intervention and performance against the Referral to Treatment (RTT) standard. Patient and professional outcome and satisfaction should also be measured.
