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Quality and Safety news: Take-Home Naloxone, stroke alert and a prostate pathway

02-Aug-2016

Take-Home Naloxone kits available in Regina

Take-Home Naloxone kits will become available in Regina through the Regina Qu’Appelle Health Region’s Harm Reduction Methadone Program beginning on July 4, 2016.

Naloxone is an injectable medication used to rapidly reverse the effects of an opioid overdose. Currently, it is used by paramedics as well as emergency departments and will be expanding into the community. When administered properly, Naloxone can remove the effects of an overdose and restore breathing to an individual experiencing an overdose within several minutes.
 
“Take-Home Naloxone kits have the potential to save lives. RQHR’s continued focus on health care services that are patient and family-centered in nature is evident in this program. Staff at the Harm Reduction Clinic continue to work with those clients with addictions to engage them in treatment for their addiction,” said Ken Akan, Program Manager in Mental Health and Addictions. 

Beginning July 4th, Take-Home Naloxone kits and training on the use of the kit will be made available free of charge to individuals that have been identified as being at risk for an opioid overdose. Clients and their concerned loved ones will be provided education on recognizing the signs of an overdose as well as training on Rescue Breathing and the Safe Administration of Naloxone in these circumstances. Once training is complete and a certificate is issued, a request for Naloxone will be filled by the Lakeshore Pharmacy and given to the client along with the kit at the Harm Reduction Clinic.

“The expansion of the Take-Home Naloxone program is an important addition to the range of services available to help at-risk individuals, and supports our government’s commitment to addressing the recommendations in the Mental Health and Addictions Action Plan,” Health Minister Dustin Duncan said. “Making this resource more accessible to those who need it has the potential to save lives and prevent injury due to overdose.”

The Saskatchewan Ministry of Health is providing $50,000 this year to fund Take-Home Naloxone programs in both Regina and Saskatoon, with funding also earmarked for expansion into other health regions.

Stroke alert information

Stroke alert patients:

Any patient with one or more of the following physical symptoms -- facial droop, arm drift, speech changes and within six hours of the last seen normal (FAST assessment), or wake-up strokes, should be taken directly to the RGH. The six hour stroke window must incorporate transportation time to RGH. 

Stroke bypass:

Canadian Best Practice Recommendations for Stroke Care support the direct transport of suspected patients to a designated facility capable of providing services for the diagnoses of hyper acute treatment of stroke. This includes centers which provide the following services -- CT/CTA, TPA administration and endovascular therapy. Royal University Hospital is the only center centre in the province capable of endovascular therapy for stroke. All acute strokes should be triaged as a CTAS 2 or 1 if unstable. 

Visit www.strokebestpractices.ca

Stroke alert window expanded to six hours and Wake-up Strokes

Recent advances in stroke intra-arterial medicine allow trained nerosurgeons and interventional radiologists to treat stroke via conventional angiography outside the 4.5 hour tPA treatment window. Wires, catheters and other devices are guided through a patient's femoral artery to the area of thrombosis. Once there, the doctor can administer clot busting medications, mechanically remove the clot with various devices or use a combination of therapies. The only trained physicians in Saskatchewan who can conduct these procedures are at the RUH in Saskatoon. 

Pre-hospital communication and registration

Canadian Best Practice for Stroke care states that paramedics should transfer care to the receiving facility with minimal delay. Receiving hospitals should be provided with information including: LSN, presenting signs and symptoms of stroke, symptom duration, GCS, patient's age and expected arrival time at the hospital. RQHR is working on a process to pre-register patients arriving via EMS with trauma alert patients. If successful we hope to expand this to stroke alerts patients to reduce in-hospital delays. 

Prostate assessment pathway

The material on the following pages was developed and/or approved by the Provincial Prostate Assessment Pathway working group. You will see there is prostate information aimed at two audiences – patients and providers. A lot of the information for patients is linked to Healthline Online.

http://www.sasksurgery.ca/patient/pathways.html

http://www.sasksurgery.ca/provider/prostate.html

The provider pages have general information for primary care providers to assist them in managing patients with prostate concerns. The Regina referral form (or provincial if we get there) and prostate alerts biopsy will be updated on the web page once all the changes are finalized. The referral form is also in physician EMRs. Again, the Regina version will be updated on the EMR once changes are finalized.