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Management of catastrophic haemorrhage in palliative head and neck cancer: creation of a new protocol using simulation

Catastrophic haemorrhage or carotid blowout a rare but devastating consequence of head and neck cancer. In most cases, this represents a terminal event, and the patient is prescribed pre-emptive analgesia and anxiolytics. There is anecdotal evidence that due to the time taken to prepare the medicati...

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Autores principales: Sooby, Paul, Tarmal, Abdurahman, Townsley, Richard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7607599/
https://www.ncbi.nlm.nih.gov/pubmed/33139295
http://dx.doi.org/10.1136/bmjoq-2020-001003
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author Sooby, Paul
Tarmal, Abdurahman
Townsley, Richard
author_facet Sooby, Paul
Tarmal, Abdurahman
Townsley, Richard
author_sort Sooby, Paul
collection PubMed
description Catastrophic haemorrhage or carotid blowout a rare but devastating consequence of head and neck cancer. In most cases, this represents a terminal event, and the patient is prescribed pre-emptive analgesia and anxiolytics. There is anecdotal evidence that due to the time taken to prepare the medications that patients do not receive these drugs prior to death. We aimed to identify the drug to patient time using simulated catastrophic haemorrhage simulations. We used the current protocol for this and also proposed a new grab-bag with preprepared anxiolytic and anagelsic medications. Each scenario was repeated 16 times. The mean time for drug administration using the current policy was 124 s compared with 48 s when the grab-bag was used (p<0.01). The new protocol also reduced the variability in the drug to patient time. We aim to implement this new protocol on the head and neck ward.
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spelling pubmed-76075992020-11-12 Management of catastrophic haemorrhage in palliative head and neck cancer: creation of a new protocol using simulation Sooby, Paul Tarmal, Abdurahman Townsley, Richard BMJ Open Qual Quality Improvement Report Catastrophic haemorrhage or carotid blowout a rare but devastating consequence of head and neck cancer. In most cases, this represents a terminal event, and the patient is prescribed pre-emptive analgesia and anxiolytics. There is anecdotal evidence that due to the time taken to prepare the medications that patients do not receive these drugs prior to death. We aimed to identify the drug to patient time using simulated catastrophic haemorrhage simulations. We used the current protocol for this and also proposed a new grab-bag with preprepared anxiolytic and anagelsic medications. Each scenario was repeated 16 times. The mean time for drug administration using the current policy was 124 s compared with 48 s when the grab-bag was used (p<0.01). The new protocol also reduced the variability in the drug to patient time. We aim to implement this new protocol on the head and neck ward. BMJ Publishing Group 2020-11-02 /pmc/articles/PMC7607599/ /pubmed/33139295 http://dx.doi.org/10.1136/bmjoq-2020-001003 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Quality Improvement Report
Sooby, Paul
Tarmal, Abdurahman
Townsley, Richard
Management of catastrophic haemorrhage in palliative head and neck cancer: creation of a new protocol using simulation
title Management of catastrophic haemorrhage in palliative head and neck cancer: creation of a new protocol using simulation
title_full Management of catastrophic haemorrhage in palliative head and neck cancer: creation of a new protocol using simulation
title_fullStr Management of catastrophic haemorrhage in palliative head and neck cancer: creation of a new protocol using simulation
title_full_unstemmed Management of catastrophic haemorrhage in palliative head and neck cancer: creation of a new protocol using simulation
title_short Management of catastrophic haemorrhage in palliative head and neck cancer: creation of a new protocol using simulation
title_sort management of catastrophic haemorrhage in palliative head and neck cancer: creation of a new protocol using simulation
topic Quality Improvement Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7607599/
https://www.ncbi.nlm.nih.gov/pubmed/33139295
http://dx.doi.org/10.1136/bmjoq-2020-001003
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