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Cardiovascular Disease, Medications and Heat: What Precautionary Advice is Available?
Abstracts
for increased inclusion of family members in their care, decision making and discharge preparation. Staff identified that access to interpreters, availability of appropriate resources (written, visual) and involvement of skilled staff assisted with communication. For some staff, not knowing how to approach and communicate with people from remote areas was a significant barrier. Conclusions and Impact: The Communicate project has highlighted both strengths and limitations in current hospital practices and skill sets. A model combining preferences of patients, family members and staff has been developed and can be used to inform needed changes. http://dx.doi.org/10.1016/j.hlc.2016.06.750 748 The South Australian Childhood Rheumatic Heart Disease Project R. Roberts-Thomson 1,∗ , G. Wheaton 2 , S. Noonan 1 , A. Brown 1 1 South
Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia 2 Womens and Children’s Hospital, Adelaide, Australia Rheumatic heart disease (RHD) is a disease of poverty and disadvantage. If diagnosed early, regular antibiotics and medical care can prevent, or at least delay, the need for surgery and premature death. A large screening program (The gECHO study) including 4000 high risk children living across the north of Australia has shown 2.6% have definite or borderline RHD however, little is known about the rates of RHD in southern parts of Australia. The South Australian Childhood Rheumatic Heart Disease Project (SACRHD) will screen 2000 school-aged Aboriginal and Torres Strait Islander children living in metropolitan, regional and remote locations across South Australia. Screening will include obtaining basic demographic information, measured height and weight, and an experienced cardiac sonographer will perform a screening echocardiogram using Vivid e or Vivid i (GE Healthcare, Germany) portable cardiovascular ultrasound machines. Screening echocardiograms will be performed using a previously validated screening protocol. Diagnoses will be made based on the World Heart Federation criteria for definite and borderline RHD. Novel cloud-based software will allow real-time diagnosis of RHD by metropolitan based paediatric cardiologists, facilitating timely treatment and establishment of an ongoing management plan. SACRHD will be the largest Australian RHD screening study conducted outside of the Northern Territory. The outcomes of the study will provide novel insights into the burden of RHD to assist communities, government agencies and relevant health staff to develop and implement necessary programs to control RHD within SA. http://dx.doi.org/10.1016/j.hlc.2016.06.751
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Social Aspects of Cardiovascular Disease (749–761) 749 Cardiovascular Disease, Medications and Heat: What Precautionary Advice is Available? N. Jeyakumaran 1,∗ , G. Gabb 2 , D. Rowett 3 , R. Tadros 4 1 University
of Adelaide, Adelaide, Australia of Medicine, Royal Adelaide Hospital, Adelaide, Australia 3 Pharmacy, The Repatriation General Hospital Daw Park, Adelaide, Australia 4 Department of General Medicine and Department of Clinical Pharmacology, Royal Adelaide Hospital, Adelaide, Australia 2 Department
Global temperatures are rising, increasing the probability of exposure to extreme heat events. Patients with cardiovascular (CV) disease may be at increased risk during extreme heat events, and CV medications may exacerbate this risk through dehydration and electrolyte imbalance- including hyponatraemia. Normal CV adaptation to severe heat stress can involve an increase in cardiac output (CO) by up to 20 L/min and a shift of heated blood from core to peripheral circulation. An inability to increase CO results in impaired heat tolerance and increased susceptibility to heat stroke. Objective: To review commonly used health professional medical resources in relation to heat-related precautionary advice for CV disease management and prescribed CV medications. Methods: A content analysis of the following Australian resources was conducted (1)Therapeutic Guideline Cardiovascular Version 6 (2)Australian Medicines Handbook 2015 (3) Australian Heart Foundation Guidelines (4) Approved Product Information for specific drugs including atenolol, metoprolol, frusemide, spironolactone, glyceryl trinitrate, perindopril, irbesartan, amlodipine, atorvastatin. Resources were searched manually for the following terms – ‘heat’, ‘weather’ and ‘season’. Results: No advice was found for health professionals regarding the potential effects of exposure to extreme heat in patients with CV disease, nor precautionary advice for people prescribed CV medications except for generic storage of medicines advice. Conclusion: Precautionary advice regarding the effects of heat in patients with CV disease and use of CV medications is not generally available. http://dx.doi.org/10.1016/j.hlc.2016.06.752
for increased inclusion of family members in their care, decision making and discharge preparation. Staff identified that access to interpreters, availability of appropriate resources (written, visual) and involvement of skilled staff assisted with communication. For some staff, not knowing how to approach and communicate with people from remote areas was a significant barrier. Conclusions and Impact: The Communicate project has highlighted both strengths and limitations in current hospital practices and skill sets. A model combining preferences of patients, family members and staff has been developed and can be used to inform needed changes. http://dx.doi.org/10.1016/j.hlc.2016.06.750 748 The South Australian Childhood Rheumatic Heart Disease Project R. Roberts-Thomson 1,∗ , G. Wheaton 2 , S. Noonan 1 , A. Brown 1 1 South
Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia 2 Womens and Children’s Hospital, Adelaide, Australia Rheumatic heart disease (RHD) is a disease of poverty and disadvantage. If diagnosed early, regular antibiotics and medical care can prevent, or at least delay, the need for surgery and premature death. A large screening program (The gECHO study) including 4000 high risk children living across the north of Australia has shown 2.6% have definite or borderline RHD however, little is known about the rates of RHD in southern parts of Australia. The South Australian Childhood Rheumatic Heart Disease Project (SACRHD) will screen 2000 school-aged Aboriginal and Torres Strait Islander children living in metropolitan, regional and remote locations across South Australia. Screening will include obtaining basic demographic information, measured height and weight, and an experienced cardiac sonographer will perform a screening echocardiogram using Vivid e or Vivid i (GE Healthcare, Germany) portable cardiovascular ultrasound machines. Screening echocardiograms will be performed using a previously validated screening protocol. Diagnoses will be made based on the World Heart Federation criteria for definite and borderline RHD. Novel cloud-based software will allow real-time diagnosis of RHD by metropolitan based paediatric cardiologists, facilitating timely treatment and establishment of an ongoing management plan. SACRHD will be the largest Australian RHD screening study conducted outside of the Northern Territory. The outcomes of the study will provide novel insights into the burden of RHD to assist communities, government agencies and relevant health staff to develop and implement necessary programs to control RHD within SA. http://dx.doi.org/10.1016/j.hlc.2016.06.751
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Social Aspects of Cardiovascular Disease (749–761) 749 Cardiovascular Disease, Medications and Heat: What Precautionary Advice is Available? N. Jeyakumaran 1,∗ , G. Gabb 2 , D. Rowett 3 , R. Tadros 4 1 University
of Adelaide, Adelaide, Australia of Medicine, Royal Adelaide Hospital, Adelaide, Australia 3 Pharmacy, The Repatriation General Hospital Daw Park, Adelaide, Australia 4 Department of General Medicine and Department of Clinical Pharmacology, Royal Adelaide Hospital, Adelaide, Australia 2 Department
Global temperatures are rising, increasing the probability of exposure to extreme heat events. Patients with cardiovascular (CV) disease may be at increased risk during extreme heat events, and CV medications may exacerbate this risk through dehydration and electrolyte imbalance- including hyponatraemia. Normal CV adaptation to severe heat stress can involve an increase in cardiac output (CO) by up to 20 L/min and a shift of heated blood from core to peripheral circulation. An inability to increase CO results in impaired heat tolerance and increased susceptibility to heat stroke. Objective: To review commonly used health professional medical resources in relation to heat-related precautionary advice for CV disease management and prescribed CV medications. Methods: A content analysis of the following Australian resources was conducted (1)Therapeutic Guideline Cardiovascular Version 6 (2)Australian Medicines Handbook 2015 (3) Australian Heart Foundation Guidelines (4) Approved Product Information for specific drugs including atenolol, metoprolol, frusemide, spironolactone, glyceryl trinitrate, perindopril, irbesartan, amlodipine, atorvastatin. Resources were searched manually for the following terms – ‘heat’, ‘weather’ and ‘season’. Results: No advice was found for health professionals regarding the potential effects of exposure to extreme heat in patients with CV disease, nor precautionary advice for people prescribed CV medications except for generic storage of medicines advice. Conclusion: Precautionary advice regarding the effects of heat in patients with CV disease and use of CV medications is not generally available. http://dx.doi.org/10.1016/j.hlc.2016.06.752