Sunday, June 30, 2013

Anticoagulation for Atrial Fibrillation: Should Emergency Physicians be Responsible?

Anticoagulation for Atrial Fibrillation: Should Emergency Physicians be Responsible?


Anticoagulation for Atrial Fibrillation: Should Emergency Physicians be Responsible?

Daniel J. Pallin, MD, MPH reviewing Scheuermeyer FX et al. Ann Emerg Med 2013 May 24.

Discharging eligible patients from the ED without anticoagulation is called inappropriate in this retrospective study.

Patients with atrial fibrillation who are at high risk for stroke should receive anticoagulants. In a retrospective study of patients with atrial fibrillation or flutter who were discharged from two Canadian emergency departments (EDs) after treatment solely by emergency physicians, researchers ascertained the proportion of eligible patients who received anticoagulation.
Of 657 patients with atrial fibrillation and 75 with flutter, 151 were deemed retrospectively to be good candidates for starting anticoagulation (CHADS score >0 and no underlying illness). Of these 151 patients, 53% had been discharged home without anticoagulation and with no reason provided by the emergency physician and no instructions to discuss anticoagulation with a primary care physician.

COMMENT

Many emergency physicians do not consider initiation of lifelong anticoagulation to be within their scope of practice. These results are best seen as a description of current practice, not as a criticism of current practice. Whether long-term anticoagulation should be initiated in the emergency department, or through timely and reliable follow-up, is a useful question, but one that has not been answered.
- See more at: http://www.jwatch.org/na31445/2013/06/27/anticoagulation-atrial-fibrillation-should-emergency#sthash.TPDgkuEQ.dpuf
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1 comment:

  1. maggie.danhakl@healthline.comApril 4, 2014 at 11:45 PM

    Hello Dr Tom,

    Healthline just designed a virtual guide of how atrial fibrillation affects the body. You can see the infographic here: http://www.healthline.com/health/atrial-fibrillation/effects-on-body

    This is valuable med-reviewed information that can help a person understand the effects of afib of their body. I thought this would be of interest to your audience, and I’m writing to see if you would include this as a resource on your page: http://ecc-education.blogspot.com/2013/06/anticoagulation-for-atrial-fibrillation.html

    If you do not believe this would be a good fit for a resource on your site, even sharing this on your social communities would be a great alternative to help get the word out.

    Thanks so much for taking the time to review. Please let me know your thoughts and if I can answer any questions for you.

    All the best,
    Maggie Danhakl • Assistant Marketing Manager
    p: 415-281-3124 f: 415-281-3199

    Healthline • The Power of Intelligent Health
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