Must Reads

3 New Clinical Guidelines To Take Note of Articles PPAHS have been reading the week January 28, 2019

Editor’s note: In this week’s must reads, we look at 3 new clinical guidelines and consider their impact on patient care.

Guideline for the Management of Patients With Atrial Fibrillation

The newly released “Guideline for the Management of Patients With Atrial Fibrillation” is a game changer for the use of anticoagulants. In a report by the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society, in Collaboration With the Society of Thoracic Surgeons, newer anticoagulants, known as non-vitamin K oral anticoagulants (NOACs), are recommended over the traditional warfarin to prevent stroke in people with atrial fibrillation (AFib).

Source: https://commons.wikimedia.org/wiki/File:Atrial_Fibrillation.jpg

Guideline for the Management of Patients With #AFib - a game changer for the use of #anticoagulants @ACCinTouch, @American_Heart, @HRSonline, @STS_CTsurgery Click To Tweet

One-Hour Sepsis Bundles

The Surviving Sepsis Campaign “encourages clinicians to act as quickly as possible to obtain blood cultures, administer broad spectrum antibiotics, start appropriate fluid resuscitation, measure lactate, and begin vasopressors if clinically indicated. Ideally these interventions would all begin in the first hour from sepsis recognition but may not necessarily be completed in the first hour.”

However, in a recent joint statement by the Society of Critical Care Medicine and the American College of Emergency Physicians recommend that hospitals do not implement the Hour-1 bundle in its present form. However, in what seems to be a hair splitting over timing, evidence has been cited that earlier delivery of antibiotics was beneficial in general, but there seems to disagreement over whether there is evidence for a one-hour timeframe. Should 65 or 55 minutes really be the question?

Unnecessary hair splitting? Hospitals should not implement one-hour sepsis bundles, say @SCCM and @ACEPNow Click To Tweet

Guidelines and Recommendations for the Management of Obstructive Sleep Apnea (OSA)

The Society of Anesthesia and Sleep Medicine recently issued, “Abbreviated Guidelines and Recommendations for the Management of Obstructive Sleep Apnea (OSA) in the Perioperative Period For Healthcare Professionals.”

These guidelines “present risk reduction strategies for preoperative evaluation,

perioperative, postoperative, post-discharge care and protocol example for the perioperative care of patients with known or suspected OSA.”

@SASM_HQ guidelines present risk reduction strategies for patients with known or suspected obstuctive #sleepapnea Click To Tweet

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