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The Statements of Principles Monitoring, Aetiology and CCPS Commentary Unit |
4th floor AMP Place, 10 Eagle St Brisbane Qld 4000.
Facsimile: 07 3223 8722. email: smaccu@powerup.com.au
Bob Connolly |
07 3223 8325 (Manager, Brisbane) |
Dr Bev Grehan |
07 3223 8376 |
Maureen Anderson |
08 8290 0365 (Manager, Adelaide) |
Dr Jon Kelley |
07 3223 8412 |
Duncan Cape |
07 3223 8757 |
Sue Lee |
08 8290 0227 |
Gaynor Cavanagh |
07 3223 8331 |
Bernadette McCabe |
07 3223 8393 |
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SOP BULLETIN # 10 |
1 April, 1998
THE FOLLOWING RMA SOPS ARE TO BE GAZETTED ON 8 APRIL 1998
New SOPs |
Cardiac Myxoma Idiopathic Fibrosing Alveolitis |
Replacement SOPs |
Cerebrovascular Accident Cardiomyopathy Psoriasis Reiter's Syndrome |
Amendments |
None |
Statements |
Thrombocytopaenia |
IMPORTANT OPERATIONAL FEATURES
Thrombocytopaenia |
Statement |
The RMA's “ STATEMENT ABOUT THE CAUSES OF 'THROMBOCYTOPAENIA' “ is referred to in the new Cerebrovascular Accident SOPs. The STATEMENT contains a definition of thrombocytopaenia, as well as a list of factors which the RMA have found to be causes of that condition, as it is defined in the STATEMENT. This STATEMENT will operate like the existing “ STATEMENT ABOUT THE CAUSES OF 'BEING OBESE' “.
Cerebrovascular Accident |
Revocation - 23 & 24 of 1998 (replacing 142 & 143 of 1996) (as amended) |
Major changes to factors
- The SOPs now contain sub-headings for each of the four categories of cerebrovascular accidents. The factors that apply to all cerebrovascular accidents are listed first (a) to (j). The factors that apply only to cerebral ischaemia are listed next under (k), followed by those that apply only to vertebrobasilar ischaemia under (m) and lastly, those that apply only to intracerebral haemorrhage under (n).
- The “stress” factor (b) has been changed to “experiencing an acute severe stressor within the 48 hours immediately before the clinical onset ”, with a new definition. This factor no longer requires temporary aggravation of established hypertension.
- There is a new factor (c) “ suffering from panic disorder ”.
- The alcohol factor (e) now requires the alcohol consumption to be contained within alcoholic drinks.
- Encephalitis and cerebral abscess have been included in the “ meningitis factor “ (f).
- The “carotid arterial disease ” factor (k)(vii) has been changed to “... a disease of the precerebral artery supplying the area of cerebral ischaemia at the time of the clinical onset ... ”. This expands the factor to include the vertebral and basilar arteries, but contains a new requirement that the artery supply the area of cerebral ischaemia.
Minor wording changes to factors to conform to standard SOP practice
General factors:
- Inflammatory vascular disease, factor (g), must now affect the cerebral vessels “ at the time of “ the clinical onset.
For cerebral ischaemia only:
- The factor for the combined oral contraceptive (k)(iv) now specifies “ regularly ingesting “ (instead of “ undergoing a course of “).
- The presence of a potential cardiac source of emboli, factor (k)(v), must now be “ at the time of “ the clinical onset (instead of “ immediately before “).
- The factor dealing with cerebral vasospasm (k)(viii) now specifies “ at the time of “ the clinical onset (instead of “ immediately before “).
For intracerebral haemorrhage only:
- The factor dealing with haemostatic failure (n)(iv) now specifies “ at the time of “ the clinical onset (instead of “ immediately before “).
Changes to Definitions
- In the CVA SOPs, thrombocytopaenia is now defined by a specified platelet level and being due to a cause specified in the RMA's “ STATEMENT ABOUT THE CAUSES OF 'THROMBOCYTOPAENIA' “. Both requirements must be met.
Multiple minor wording changes to reflect changes to the SOP factors and some ICD code adjustments.
Cardiomyopathy |
REVOCATION - 19 & 20 of 1998 (replacing 93 & 94 of 1996) |
Changes to factors
- There is a new causal and aggravating factor (y) for thiamine deficiency (beriberi).
Psoriasis |
REVOCATION - 21 & 22 of 1998 (replacing 7 & 8 of 1996) |
- A new, more detailed definition of Psoriasis.
- New factors dealing with “ clinical worsening “ (i.e aggravation) namely:
- a clinically significant anxiety disorder or depressive disorder (f);
- alcohol dependence or abuse (e); and
- the drugs chloroquine, hydroxochloroquine and interferon alpha (d).
Reiter's Syndrome |
Revocation - 17 & 18 of 1998 (replacing 31 & 32 of 1994) |
Changes
- A new, simpler but more precise definition of Reiter's syndrome.
- Time periods in all of the factors (except the “ appropriate clinical management “ factor) now 60 days for the RH SOP, and 30 days for the BOP SOP.
Idiopathic Fibrosing Alveolitis |
New - 15 & 16 of 1998 |
A specific lung condition, which is not uncommon. The only factor is “ inability to obtain appropriate clinical management ”.
Cardiac Myxoma |
New - 13 & 14 of 1998 |
Cardiac Myxoma is a benign neoplasm of the heart. It is a very rare condition.
REMEMBER ! If you have any questions about SOPs or SOPs-in-CCPS, the SMACC Unit is only a 'phone call or an e-mail message away.