Pharmacists in the emergency department play a crucial role in upfront decision making around medicines for patients presenting with various medical conditions.
Cristina Roman, is the Lead Pharmacist at Alfred Emergency Trauma Centre. In her 12 years working in the Emergency Department, Cristina has established pharmacy services, and filled gaps in patient care with new models of care.
One of those models of care adopted by the US and other countries, is involving pharmacists for critically unwell patients that present to the emergency department.
Through her investigations, Cristina has considered how pharmacy services can impact stroke care, sepsis and trauma outcomes.
Thrombolytic therapy is crucial in ischaemic strokes, as every minute with a blood clot in the brain increases the risk of permanent disability for the patient.
Pharmacists can play a crucial role in identifying patients appropriate for thrombolysis and assisting with the administration of high-risk medications like thrombolysis for stroke patients. This can mean faster thrombolysis to eligible patients, shaping the scope of practice for the emergency medicine pharmacist.
In addition, her studies have also shown the involvement of pharmacists in sepsis calls improves time to antibiotic administration, particularly for patients in ICU care. The evidence has shown better outcomes for the most unwell patients.
Nurses and medical staff at Alfred Hospital are now actively pulling pharmacists into scenarios, highlighting the value and benefit of their involvement in patient care.
This model of care for emergency departments involving pharmacists has gained international interest and is continuing to expand.
Australian Health Journal spoke with Cristina Roman and Lisa Bremner, Advanced Training Resident Pharmacist at Alfred Hospital Emergency Trauma Centre.
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‘Without an adequate amount of thyroid hormone mothers can be exposed to hypertensive disorders of pregnancy, including gestational hypertension and preeclampsia or eclampsia, which affect around 10% of pregnant women and are the leading causes of maternal and neonatal mortality worldwide. Mothers who suffer from hypertensive disorders during pregnancy are at increased risk of long-term cardiovascular consequences and hypertensive disorders in subsequent pregnancies. Evidence also indicates a risk of reduced cognitive ability to their offspring.
‘Knowing if you are genetically predisposed to Hashimoto’s or Graves’ Diseases, which are both thyroid autoimmune disorders is important to be aware of, to ensure all appropriate tests are ordered. Autoimmune disorders may predispose mothers to a thyroid problem during pregnancy’, says Professor Creswell Eastman, who also serves as the ATF’s Principal Medical Advisor.
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