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How tech is transforming healthcare

How tech is transforming healthcare

1

Wearables

Data captured from health devices could provide precious information to provide accurate care to the patients.
As we noticed wearable gadgets are increasing in numbers as well as accuracy.

2

Augmented Reality

Allowing the healthcare providers to jump instantly between patients, or view organs, or even project radiology images over the body during operations to reduce mistakes.
Combining live video-streaming with Augmented Reality surgeons carrying out operations are able to consult the other side of the world. Who says that you can’t be in two places at once?

3

Online Consultation

The patient, who can afford it, can always consult with their preferred healthcare providers online and even afford a sort of on-call medical service, other than emergency services.

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innohep – tinzaparin sodium

Bringing the freedom to focus

innohep®

tinzaparin sodium


Get ready to meet your new friend


“A baby is something you carry inside you for nine months, in your arms for three years, and in your heart until the day you die.”

- Mary Mason -

Antenatal assessment and management (to be assessed at booking and repeated if admitted)

Any previous VTE except a Single event related to major surgery

HIGH RISK

Requires antenatal prophylaxis with LMWH
refer to trust-nominated thrombosis in pregnancy expert/team

Hospital admission

Single previous VTE related to major surgery

High-risk thrombophilia + no VTE

Medical comorbidities e.g. cancer, heart failure, active SLE, IBD or inflammatory polyarthropathy, nephrotic syndrome, type 1 DM with nephropathy, sickle cell disease, current IVDU

Any surgical procedure e.g. appendicectomy

OHSS(first trimester only)

INTERMEDIATE RISK

Consider antenatal prophylaxis with LMWH

Obesity (BMI > 30KG/M2)

Age

Parity ≥ 3

Smoker

Gross varicose veins

Current pre-eclampsia

Immobility, e.g. paraplegia, PGP

Family history of unprovoked or estrogen-provoked VTE in first-degree relative

Low-risk thrombophilia

Multiple pregnancy

IVF/ART

Transient risk factors:

Dehydration/hyperemesis; current systemic infection; long-distance travel

Fewer than three risk factors

Four or more risk factors:
Prophylaxis from first trimester

Three risk factors:
Prophylaxis from 28 weeks

LOWER RISK

Mobilisation and avoidance of dehydration

For more information

Regarding the timing of first antenatal and/or postnatal thromboprophylactic dose; please refer to RCOG Green-Top Guideline No. 37a (thrombosis and Embolism during Pregnancy and the Puerperium, Reducing the risk - Published 13/04/2015)

Postnatal assessment and management (to be assessed on delivery suite)

Any previous VTE
anyone requiring antenatal LMWH
High-risk thrombophilia
Low-risk thrombophilia + FHx

HIGH RISK

At least 6 weeks, postnatal prophylactic LMWH

caesarean section in labour

BMI ≥ KG/M2

Readmission or prolonged admission (≥3 days) in the puerperium

Any surgical procedure int the puerperium except immediate repair of the perineum

Medical comorbidities e.g. cancer, heart failure, active SLE, IBD or inflammatory polyarthropathy, nephrotic syndrome, type 1 DM with nephropathy, sickle cell disease, current IVDU

INTERMEDIATE RISK

At least 10 days postnatal prophylaxis with LMWH

NB if presisting > 3 risk factors; consider extending thromboprophylaxis with LMWH

Age > 35 years
Obesity (BMI > 30KG/M2)
Parity ≥ 3
Smoker
Elective caesarean section
Family history of VTE
Low-risk thrombophilia
Gross varicose veins
Current systemic infection
Current pre-eclampsia
Immobility, e.g. paraplegia, PGP, long-distance travel
Multiple pregnancy
Preterm delivery in this pregnancy (<37+0 weeks)
Stillbirth in this pregnancy
Mid-cavity rotational or operative delivery
Prolonged labour (< 24 hours)
PPH > 1 litre or blood transfusion
Family history of unprovoked or estrogen-provoked VTE in first-degree relative
Low-risk thrombophilia
Multiple pregnancy
IVF/ART
Two or more risk factors
Fewer than two risk factors

LOWER RISK

Mobilisation and avoidance of dehydration

Antenatal and post natal prophylactic dose of LMWH

Weight < 50KG = 20MG enoxaparin / 2500UNITS dalteparin / 3500UNITS tinzaparin daily.
Weight 50-90KG = 40MG enoxaparin / 5000UNITS dalteparin / 4500UNITS tinzaparin daily.
Weight 91-130KG = 60MG enoxaparin / 7500UNITS dalteparin / 7000UNITS tinzaparin daily.
Weight 131-170KG = 80MG enoxaparin / 10000UNITS dalteparin / 9000UNITS tinzaparin daily.
Weight > 170KG = 0.6MG/KG enoxaparin / 75UNITS/KG dalteparin / 75UNITS/KG tinzaparin daily.

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octaplex – Prothrombin Complex Concentrate

Accurate prevention and fast control of life-threatening bleeding.
octaplex® provides a rapid and complete reversal of vitamin K antagonists (VKA) induced coagulopathy due to:
  • Easy storage at room temperature and quick availability.
  • Small infusion volume with no risk of fluid overload.
  • Short infusion time.
  • No need for blood type matching.
  • Balanced content of vitamin K coagulation factors and inhibitory proteins.
octaplex is ready to be used in life-threatening bleeding, unlike FFP:

octaplex®

FFP

20-40ML

2100ML (30ML/KG)

10 minutes

14-50 hours

Blood matching not required

Blood matching is required

Used immediately in room temperature

-25°C
thawing time: 30 minutes

References:
  1. Dowlatshahi, D., Butcher, K. S., Asdaghi, N., Nahirniak, S., Bernbaum, M. L., Giulivi, A., … Coutts, S. B. (2012). Poor Prognosis in Warfarin-Associated Intracranial Hemorrhage Despite Anticoagulation Reversal. Stroke43(7), 1812-1817. doi:10.1161/strokeaha.112.652065
  2. Lubetsky, A., Hoffman, R., Zimlichman, R., Eldor, A., Zvi, J., Kostenko, V., & Brenner, B. (2004). Efficacy and safety of a prothrombin complex concentrate (Octaplex®) for rapid reversal of oral anticoagulation. Thrombosis Research113(6), 371-378. doi:10.1016/j.thromres.2004.04.004
  3. Management of severe perioperative bleeding. (2014). European Journal of Anaesthesiology31(4), 247. doi:10.1097/eja.0000000000000066
  4. Varga, C., Al-Touri, S., Papadoukakis, S., Caplan, S., Kahn, S., & Blostein, M. (2012). The effectiveness and safety of fixed low-dose prothrombin complex concentrates in patients requiring urgent reversal of warfarin (CME). Transfusion53(7), 1451-1458. doi:10.1111/j.1537-2995.2012.03924.x

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IV ADMIXTURE HIS Module

Iv admixture is a major deal in any healthcare facility; therefore, the pharmacy is currently brainstorming with the IT department to develop an interface to manage all IV admixtures from physicians, nurses as well as from pharmacy side.

I chose to start with imagining the label for the final product, and added to most of the needed info.

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Himss Certification

Got a call from our IT department informing me about getting selected for a task force to get the himss certification for our current HIS. I'm really looking forward to start this project; as we've already been working on a way to improve the Inpatient pharmacy dashboard and all other related modules.

Will be posting updates here once things started to roll on.


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New Clinical Support System

Image via logomakr.com

I just received a note that the hospital I’m working in will start a new adaptation of a fully functional clinical support system, and the management decided to include me in the team populating the data tables for the IT department to start the project… YAY!!!

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