An audit of the management of heart murmurs on the postnatal wards
| Autor: | Judith Simpson, KM O’Reilly, C Cunningham, FM Hall, T Richens |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Heart Defects
Congenital Medical Audit Pediatrics medicine.medical_specialty Heart Murmurs medicine.diagnostic_test business.industry Infant Newborn Physical examination General Medicine Audit Discharge home Guideline Patient Discharge Neonatal heart Practice Guidelines as Topic medicine Heart murmur Humans Case note Prospective Studies medicine.symptom business Hospital Units Follow-Up Studies |
| Zdroj: | Scottish Medical Journal. 58:e11-e14 |
| ISSN: | 2045-6441 0036-9330 |
| DOI: | 10.1177/0036933012474603 |
| Popis: | Background Investigation and management of neonatal heart murmurs varies widely and is dependent on local resources. In order to standardise the management of heart murmurs in our hospital a guideline (based on clinical examination with selective cardiology review) was introduced. Aims To establish adherence to and safety of the guideline; to review workload implications and to define the causes of neonatal heart murmurs in our population. Methods Patients were prospectively identified over a 2-year period (August 2006 to July 2008). Case notes were reviewed and examination findings, investigations, follow up and diagnosis recorded. Results 89 babies were identified. The guideline was generally well adhered to. In total 51 (57%) of babies were referred for cardiology assessment. In 40 babies this assessment included an echocardiogram. 30 babies (34%) had an underlying cardiac malformation: 25 were identified before discharge home. 15/30 (50%) of the babies with a cardiac malformation remain under cardiology follow up at the age of 1 year. No baby discharged from follow up without cardiology review subsequently presented with a cardiac problem. Conclusion A significant minority of babies with a heart murmur have an underlying cardiac malformation. Our guideline appears to ensure the timely identification of these babies and rationalises our use of specialist services. |
| Databáze: | OpenAIRE |
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