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Nursing staff could play a major part in detecting heart disorders Draft guidance on how to diagnose and treat a potentially life-threatening heart rhythm disorder has been issued to healthcare workers. The National Institute for Health and Care Excellence (NICE) is updating guidance on atrial fibrillation (AF), a condition that causes the heart to beat irregularly and increases the risk of stroke fivefold. Just over one million people in the UK are affected by AF, which is responsible for 22,500 strokes every year. Symptoms include palpitations, chest pains and shortness of breath, but up to one third of people with AF experience no symptoms. The draft guidance, published last week, includes recommendations on how to treat the condition, including using anti-clotting drugs to reduce the risk of stroke and antiarrhythmic drugs to restore or maintain a normal heart rhythm. Non-drug treatments could include electrical cardioversion, which ‘shocks’ the heart back to its normal rhythm. Patients should be offered medication to control their heart rate in the first instance, but be referred promptly for specialist care if current treatment fails to control the symptoms, the guidance states.

SPL

By Kat Keogh

Simple pulse checks could aid diagnosis

The guidance was last revised in 2006 and NICE centre for clinical practice director Mark Baker said advances in treatment meant an update was needed: ‘It is important that people with AF are diagnosed properly and have their condition managed effectively to reduce the significant risk of stroke and prevent deterioration in quality of life.’ Clinicians are also advised to estimate an AF patient’s risk of stroke

and bleeding by using a questionnaire which takes into account a patient’s age, sex and existing conditions. Bristol Heart Institute arrhythmia nurse specialist Carolyn Shepherd said nurses, especially those working in the community, could play an important role in detecting AF through simple pulse checks. ‘AF affects around 2 per cent of the population, so it is something nurses will encounter,’ said Ms Shepherd, who helps raise awareness of the heart rhythm disorder with the Atrial Fibrillation Association. ‘Taking the time to do a pulse check if a patient is over 50 or has unexplained breathlessness or chest pain could help detect if AF is the cause. It is free, takes seconds and could help patients get the treatment they need,’ she added. Members of NICE’s guidance development group included South Tees Acute NHS Foundation Trust cardiology specialist nurse John Campbell and Addenbrooke’s Hospital cardioversion and cardiac rehabilitation specialist nurse Nick Mills. The draft guidance is open for consultation until February 26, with a final version due to be published in June. Go to tinyurl.com/NICEdraft-AF

Care pathway must meet needs of diverse communities New end of life care guidance must have a strong emphasis on the needs of black and minority ethnic communities (BME), according to a leading cancer charity. Marie Curie Cancer Care called on NHS England to ensure that whatever replaces the Liverpool Care Pathway (LCP) includes a strong emphasis on the cultural diversity of BME communities. The charity published a paper urging the

government, NHS England and other policymakers in the health sector to take urgent steps to ensure that the end of life care needs of people from diverse communities are met. This builds on a report published in June 2013 by Marie Cure and Public Health England that found end of life needs for people from BME backgrounds are varied, growing and

inadequately understood or met. A government-commissioned review published in July 2013 recommended that the LCP, which provides palliative care guidance for the last few days of life, should be phased out. Read the paper Next Steps: Improving End of Life Care for Black, Asian and Minority Ethnic People in the UK at tinyurl.com/marie-curie-guide

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Care pathway must meet needs of diverse communities.

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