[CARPA] Re: cardiac thrombolysis in remote areas.

[Sabina Knight]

The CARPA guidelines 4th edition recommend Thrombolytcs once diagnosis is confirmed. it is kept in remote clinics and given under remote advice and support. There was some resistance earlier, generally it is now excepted that time is muscle and that remote people who have high risk of cardiovascular events should have access to safe high quality treatment that is evidence based. To date there have not been any adverse events that I'm aware of. CARPA guidelines are policy for all in the NT and the 3 states of Central Australia  and are are used in SA and north WA.
 
The REC program has been the mainstay for most RANs and provided training for remote practitioners - not all have been able to access it.
 
Sabina
 
Sabina Knight
Senior Lecturer Remote Health Practice & CRANA Research Fellow
Centre for Remote Health
Ph 61 8 89514709
Mob 0417823933
 


>>> "EriK Van Den Berg" <erik_vandenberg at health.qld.gov.au> 19/01/2007 9:01 am >>>



Just wondering if any of the remote areas are keeping and using Thrombolytics in their clinics for administration by NURSES under the direction of a remote doctor.
 
In the Cape York area a few of the clinics keep Tenecteplase but there is no consistant policy as to who, when, how etc.
 
A quick read of info on the internet shows that paramedics are using thrombolytics in remote areas of Scotland * where they may be a few hours away by road from the nearest hospital.
 
Locally there is some resistance from some people regarding the ability of remote nurses to manage reperfusion arrhythmia’s.
 
Has any-one else been down this road and managed to get suitable guidelines and protocols and training in place?
 
If so it would be great to hear about it.
 
Thanks
 
Erik
Erik van den Berg
Outreach Pharmacist
Cairns Base Hospital
PH 4050-6287
FAX 4050-6585

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