[CARPA] Re: cardiac thrombolysis in remote areas.

[Sabina Knight]

Erik, I don't think it should be restricted other than a RAN should do a
consult prior to giving it. REC is the Remote Emergency care course run
by CRANA - it has both trauma and medical emergencies. updates should
also be provided by or access made available by the employer.
 
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> 30/01/2007
2:22:57 pm >>>
Thanks Sabina,
 
What is the REC programme? Is there a module develpped specifically for
thrombolysis?
>From the replies to my original question it seems that QLD is one of
the few places that has no consistant availability of Tenecteplase (or
equiv).
 
The remaining question would be - what sort of training is in place for
nurses that are going to give thrombolytics? Is it restricted to certain
qualified nurses or is it treated just like any other drug out there?
 
Erik
 
 
 
Erik van den Berg
Outreach Pharmacist
Cairns Base Hospital
 
PH 4050-6287
FAX 4050-6585

>>> Sabina.Knight at flinders.edu.au 01/30/07 2:25 pm >>>
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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