CIAP Newsletter

Cardiovascular disease is one of Australia's largest health problems, according to the Heart Foundation, killing one Australian every 12 minutes. February 2016 is Heart Research Australia's Heart Research Month, with its website providing information and resources to continue research into the prevention and treatment of cardiovascular disease, coronary heart disease and heart attack.

The Clinical Information Access Portal (CIAP) provides access to clinical information and resources to support clinicians working with patients suffering cardiovascular disease. A good place to start is the Cardiovascular Specialty Guide, located by selecting ‘Specialty Guides & Links’ from CIAP's left menu. Here you will find recommended CIAP resources, a selection of online journals and books along with NSW Health and other recommended guidelines and websites.

A popular CIAP resource is the Interactive ECG, which can assist in developing skills and knowledge relating to electrocardiograms (ECGs). It provides ECG theory with topics available including interpreting the normal ECG, tachycardias, ventricular conduction disorders, and recording an ECG. Interactive problems include topics on myocardial infarction, myocardial ischaemia, tachycardias, bradycardias and rhythm disorders. Problems involve a short case history, ECG printout and a series of quiz questions. The quizzes are suitable for current staff and students and range from basic ECGs to more advanced ECG cases involving less common conditions.

Another useful source of information is BMJ Best Practice. Select ‘Show Conditions’ on the BMJ Best Practice homepage to view a list of available topics. Selecting ‘Cardiothoracic surgery’ will allow you to view topics including aortic dissection, atrial myxoma, cardiac tamponade, mitral stenosis and thymic tumour. Selecting ‘Cardiovascular disorders’ will allow you to view topics including bradycardia, chronic congestive heart failure, diabetic cardiovascular disease, peripheral vascular disease and unstable angina. Topics include a summary and definition of the condition, diagnostic and treatment steps, evidence tables, images and patient information leaflets.

If you are interested in improving your physical diagnosis skills, then the Auscultation Assistant may be of use. It provides recorded audio of heart sounds, heart murmurs and breath sounds along with a theory analysis of the audio and what to listen for. To find a comprehensive list of medical equations, clinical criteria and decision trees such as Diffusing capacity for carbon monoxide (DLCO) corrected for anemia or Oxygen Content of Arterial Blood; Cardiovascular Risk Assessment, Chest Pain Score, Heart Failure Diagnosis, Heart Failure Clinical Prediction Rule, and Warfarin Dosing Nomogram, visit MedCalc 3000 through ‘Tools’ in CIAP's left menu. You can select ‘Specialties’ from the MedCalc homepage and then choose ‘Cardiology’ to see the full selection.

To learn more about the range of resources available through CIAP, visit the Learning Centre for a range of workshops, user guides, elearning modules and video tutorials.

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CIAP Update

Journals and Books from Elsevier

The publisher Elsevier has discontinued the resource Mosby's Nursing Consult. The key nursing journals and books that were provided by Nursing Consult remain available in full text through the Full Journal List and Full Book List links located from either 'Journals' or 'Books & Dictionaries' in CIAP's left menu. You can browse these lists for specific journal and book titles or topics using the search box presented on the page.


Article in Focus

Physical Activity and Risk of Coronary Heart Disease and Stroke in Older Adults

Circulation 133(2): 12 January 2016, p 147-155


Although guidelines suggest that older adults engage in regular physical activity (PA) to reduce cardiovascular disease (CVD), surprisingly few studies have evaluated this relationship, especially in those >75 years.

This large prospective study among 4207 US men and women assessed the long-term effects of PA over 10 years. Greater PA was inversely associated with coronary heart disease, stroke (especially ischemic stroke), and total CVD, even in those >=75 years. Walking pace, distance, and overall walking score, leisure-time activity, and exercise intensity were each associated with lower risk.

These data provide empirical evidence supporting PA recommendations, in particular, walking, to reduce the incidence of CVD among older adults.

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Gems on CIAP

Resuscitation Council Guidelines and Flowcharts

The Australian Resuscitation Council (ARC) provides a wealth of information regarding the teaching and practice of resuscitation. Its Guidelines section displays a list of guidelines for resuscitation, first aid, education and life support. Section 8 Cardiopulmonary Resuscitation has recently been updated and published in January 2016. Section 9.2 First Aid Guidelines also provides updated sections on recognition and first aid management of heart attack (guideline 9.2.1) and stroke (9.2.2), both published in January 2016.

Section 14 Acute Coronary Syndromes (ACS) provides 5 guidelines; the majority have been updated and published in January 2016:

  • ACS: Overview & Summary
  • ACS: Presentation with ACS
  • ACS: The use of a Gastro Intestinal Cocktail for the Diagnosis of Acute Coronary Syndrome in Adult Emergency Department Patients Presenting with Chest Pain
  • ACS: Initial Medical Therapy
  • ACS: Reperfusion Strategy

At the top of the guidelines section is a useful Glossary of Terms button, which provides easy-to-view definitions of the terms utilised within the ARC website and guidelines. Simply hover your mouse over the terms in the list to view each definition.

Another useful feature of the ARC website is the Flowcharts section, which allows you to download and print a selection of Australian Resuscitation Council flowcharts including ANZCOR Adult Cardiorespiratory Arrest Flowchart, ANZCOR Neonatal Flowchart, and ANZCOR Paediatric Cardiorespiratory Arrest Flowchart among others.

The ARC website can be found through 'Guidelines' in CIAP's left menu.

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