ICU/HDU and Cardiology Clinical Stream Meeting
Thursday 12th June 2008
Attendees: Professor Fletcher, Martin Rowley, Chris Trethewy, Bruce Bastian, Jane Kerr and Karen Chronister
Item
Discussion
Scope of Streams

Cardiology Stream: Focus outside big hospitals, including CCU
as well as broader range of cardiology issues.

ICU Stream: Represents ICU/HDU and Retrieval for all HNE ICU’s.

Cardiac Retrieval Patients often fall into category B (this means
they have potential for deterioration rather than actually being
critically ill). Managing transport for this group requires further
discussion.
There are a broad range of treatment options for cardiac conditions.
There is a need to increase standardisation of care to improve
consistency. State wide guidelines will soon become available.
Intra aortic balloon pump certification for helicopter transport is not
completed but is in progress
The cardiology transport nurse system has proven very effective in
the metropolitan area. Strategies for increasing its range were
discussed (eg use of cardiology transport nurse on the helicopter
for category B transfers).
Retrieval/transport



Cardiology referral boundaries

HNEAHS boundaries and cardiology service boundaries are not
identical, particularly with respect to pacing services on the Mid
Action/Decision

Chris Trethewy
Item
Discussion

Interventional/cardiac support in
Tamworth





Action/Decision
North Coast. Agreed to keep this item under review.
Cardiology services have been increased in Tamworth. Funding for
pacemaker services has been submitted for consideration
Interventional Cardiology services have increased despite finite
CCU beds in the unit. This increases CCU pts into HDU beds and
compromises critical services
Discussed option to increase monitored beds into ward 3- stroke.
Vascular unit. Issues around role delineation surrounding those
beds and burden on ICU MOs.
Independent unit is a good initiative but need VMO as director, and
clearly defined responsibilities regarding alarms and who is
responsible for patients.
Advanced cardiology trainee for Tamworth roll out not defined with
role delineation and job description. Processes currently underway
to clearly define roles and responsibilities of advanced trainee –
different to JHH.
Need standardisation post stent management and to streamline
admission and discharge process
Failed lysis

Role of angioplasty at Tamworth: Current evidence for rescue
.angioplasty unclear and response regarding transfer of such
patients is not uniform. An agreed guideline would be useful.
Time critical transfers

Process of transfer of category B patients is complex. Retrieval
medical consultation is sometimes required to smooth the process.

Bruce Bastian to follow
up

Prof Fletcher to revisit
issues with
committee/stakeholder
group. Looking at
redesign strategies and
23hr beds etc

Prof Fletcher will
undertake to get
agreement from
colleagues.
Item
Discussion
Agreed that Retrieval staff have expertise regarding timing and
vehicle selection.
Next meeting

It was agreed that there would be a further meeting later in the year.
Action/Decision