
May 2014
don't forget to update the issue and next review variables!!!
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Changes in this release
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Topic or section
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Brief description
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Reviewer
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Verbal Orders
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Updated - please follow link for correct policy.
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Meghan Heaphy
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Chronic Lymphocytic Leukaemia
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CLL FCR500 PO chemo chart updated.
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Jenny Roberts
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Cardiac Risk According to Donor Characteristics
Low
- Good exercise tolerance.
- No history of angina.
- No diabetes.
- No history of previous myocardial infarction or cardiac failure.
- Normal electrocardiogram.
Active, asymptomatic patients with prior complete percutaneous coronary revascularisation (PTCA) six months to five years previously, or prior complete surgical revascularisation (CABG) up to five years previously.
Moderate
- Known stable ischaemic heart disease (angina on moderate or more exercise, no rest or nocturnal pain and no previous myocardial infarction).
- History of cardiac failure (but now controlled).
- Arrhythmias (controlled).
- More than three risk factors (age over 65, angina, myocardial infarction more than six months previously, hypertension, diabetes, ventricular ectopic beats, and smoking, major emergency surgery).
High
- Poorly controlled or unstable ischaemic heart disease.
- Myocardial infarction within the previous three months.
- Impaired left ventricular function
- Signs of cardiac failure (ie. raised jugular venous pressure, third heart sound, pulmonary oedema).
- Severe aortic stenosis.
Donors at low cardiac risk should not need any further investigations. Donors at high risk should be referred for anaesthetic/cardiac assessment. Donors with any moderate risk features should have an ECG and CXR and referral for anaesthetic review before a GA.
1Cardiac risk assessment for non-cardiac surgery. FM Stewart. Technical Report to Medical and Allied Professions. No 71. The National Heart Foundation of New Zealand, PO Box 17160, Greenlane, Auckland 1130.
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Donors with any moderate cardiac risk features should have an ECG and CXR and referral for anaesthetic review before a GA.
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Andrew Butler
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Topic Code: 103385