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<DIV>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.</DIV>
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<DIV>The REC program has been the mainstay for most RANs and provided training for remote practitioners - not all have been able to access it.</DIV>
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<DIV>Sabina</DIV>
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<DIV><EM><FONT color=#ffb164>Sabina Knight</FONT></EM></DIV>
<DIV><EM><FONT color=#ffb164>Senior Lecturer Remote Health Practice & CRANA Research Fellow</FONT></EM></DIV>
<DIV><EM><FONT color=#ffb164>Centre for Remote Health</FONT></EM></DIV>
<DIV><EM><FONT color=#ffb164>Ph 61 8 89514709</FONT></EM></DIV>
<DIV><EM><FONT color=#ffb164>Mob 0417823933</FONT></EM></DIV>
<DIV> </DIV><BR><BR>>>> "EriK Van Den Berg" <erik_vandenberg@health.qld.gov.au> 19/01/2007 9:01 am >>><BR><BR><BR></DIV>
<P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><FONT face="Times New Roman" size=3>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.</FONT></P>
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<P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><FONT face="Times New Roman" size=3>In the <?xml:namespace prefix = st1 ns = "urn:schemas-microsoft-com:office:smarttags" /><st1:place>Cape York</st1:place> area a few of the clinics keep Tenecteplase but there is no consistant policy as to who, when, how etc.</FONT></P>
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<P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><FONT face="Times New Roman" size=3>A quick read of info on the internet shows that paramedics are using thrombolytics in remote areas of <st1:country-region><st1:place>Scotland</st1:place></st1:country-region> - where they may be a few hours away by road from the nearest hospital.</FONT></P>
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<P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><FONT face="Times New Roman" size=3>Locally there is some resistance from some people regarding the ability of remote nurses to manage reperfusion arrhythmia's.</FONT></P>
<P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><o:p><FONT face="Times New Roman" size=3> </FONT></o:p></P>
<P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><FONT face="Times New Roman" size=3>Has any-one else been down this road and managed to get suitable guidelines and protocols and training in place?</FONT></P>
<P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><o:p><FONT face="Times New Roman" size=3> </FONT></o:p></P>
<P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><FONT face="Times New Roman" size=3>If so it would be great to hear about it.</FONT></P>
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<P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><FONT face="Times New Roman" size=3>Thanks</FONT></P>
<P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><o:p><FONT face="Times New Roman" size=3> </FONT></o:p></P>
<P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><FONT face="Times New Roman" size=3>Erik</FONT></P>
<P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><FONT face="Times New Roman" size=3>Erik van den Berg<BR>Outreach Pharmacist<BR>Cairns Base Hospital</FONT></P>
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