The Use of QT Prolongation Risk Factor Assessment Tool to Assess the Risk of QT Prolongation in Patients Taking Methadone: An Irish Experience
Issue:
Volume 7, Issue 5, October 2021
Pages:
75-80
Received:
4 May 2021
Accepted:
17 May 2021
Published:
16 September 2021
Abstract: Currently, no tool exists to assist doctors in estimating their patients’ risk of QT prolongation. Methadone is one of many medications which is known to prolong a patient’s QT, and which can lead to Torsades de Pointes and sudden cardiac death. The aim of the study was to design a QT prolongation risk factor assessment tool, for patients taking methadone, which would allow physicians to objectively assess a patient’s risk of QT prolongation. Following a literature review a QT prolongation risk factor assessment tool was created. An audit was then carried out to see what risk factors for QT prolongation were identified prior to use of the tool, in our practice, and then after the tool had been introduced. The introduction of a dedicated QT risk factor assessment tool led to an 61% (39/100 to 100/100) increase in the documentation of individual QT prolongation risk factors in our patients. There was a 100% (4/4) increase in the documentation of risk of QT prolongation in the patient notes, of discussion that risk with patients (4/4), and of the frequency of repeat ECGS (4/4). The introduction of such a QT prolongation risk factor assessment tool in our practice led to an increased awareness of QT prolonging medications, an improvement in the documentation of QT prolonging risk factors and a change in the culture of the practice around medication prescribing and QT prolongation. In patients who are on methadone, a QT prolongation risk factor assessment tool allows for an objective assessment of each patient’s risk of QT prolongation which then allows for measures to be put in place to monitor and address this risk.
Abstract: Currently, no tool exists to assist doctors in estimating their patients’ risk of QT prolongation. Methadone is one of many medications which is known to prolong a patient’s QT, and which can lead to Torsades de Pointes and sudden cardiac death. The aim of the study was to design a QT prolongation risk factor assessment tool, for patients taking me...
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Diagnosis and Therapy of Liquid Collections Under Ultrasound Control
Atanas Dimitrov Hilendarov,
Alexandar Asenov Georgiev,
Lyubomir Georgiev Chervenkov
Issue:
Volume 7, Issue 5, October 2021
Pages:
81-85
Received:
11 November 2020
Accepted:
7 December 2020
Published:
17 November 2021
Abstract: Purpose: We present our experience in the diagnosis, follow-up and planning therapy of thoracic, abdominal and retroperitoneal liquid collections in different emergency patients using conventional and interventional ultrasound. Material and Methods: The right and left oblique and poly positionning view was used in 235 patients (159 male and 76 female) for US examination to identify fluids in the thorax and peritoneal or retroperitoneal space. The examination was performed after the clinical survey with patients supine. Positive findings of US were compared with those provided by CT, punctures under US control or surgery. US machine supplied with linear and convex transducers, CT machine, needles and catheters were used. Results: 197 of all 235 US examined patients had fluid collections, confirmed by CT scan, surgery or clinival course. In 156 patients we performed FN diagnostic punctures under US control. There was 155 true-positives, 25 true-negatives, 5 false-positives and 2 false-negative results. Overall this demonstrated that ultrasonography hamaunt of d a sensitivity of 98.72%, specificity of 83.33% and accuracy of 96.25%. The PPV is 96.87% and the NPV – 92.59%. Conclusions: Our experience and literature reports support the opinion that US examination can and should be used as a primary method for diagnosis and follow-up of clinically suspected free and organaised fluids in the thorax, abdomen and retroperitoneum.
Abstract: Purpose: We present our experience in the diagnosis, follow-up and planning therapy of thoracic, abdominal and retroperitoneal liquid collections in different emergency patients using conventional and interventional ultrasound. Material and Methods: The right and left oblique and poly positionning view was used in 235 patients (159 male and 76 fema...
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