PURPOSE:
To provide guidance, information and a standardized process for health care professionals in emergency departments (ED) and inpatient units to identify and manage patients with Intermediate Risk (submassive) or High Risk (massive) Pulmonary Embolism (PE) and consulting of Pulmonary Embolism Response Team (PERT)

New CLI.4510.SG.008

Background:

• The Emergency Department Council has reviewed the following Shared Health Clinical Guideline approved them for use in SH-SS.
• The provincial PERT Clinical Practice Guideline: Treatment and Referral Guidelines for High-Risk and Intermediate-Risk Pulmonary Embolism in Adult outlines practice standards and guidance for identifying and managing patients and for consulting the Pulmonary Embolism Response Team (PERT).

Key Message:

• To provide a rapid response to manage confirmed or highly suspected acute PE in adult patients by utilizing the PERT pathway.
• To provide SH-SS physicians and nurses access via StaffNET to the Shared Health Clinical Practice Guidelines for use.

Recommendation(s)/Action Required:

• Medical Leads, site Directors, Manages and Clinical Resource Nurses familiarize yourselves with the available clinical guideline, algorithms and communications available from Shared Health.
• Ensure relevant resources are available to support teams to ensure timely access to this service.
  • Provincial Clinical Guideline: Treatment and Referral Guidelines for High-Risk and Intermediate-Risk Pulmonary Embolism in Adult Patients
  • PERT Algorithm
  • PERT Highlights Resource

Timeline: As soon as possible.

Questions:

Contact your site manager or director.

Please access the correspondence from the Manitoba Health, Seniors and Long-Term Care/Public Health dated March 7, 2025.

Please distribute this message to all health care providers and other relevant individuals.

For updates:

Contact Angela Peck, Manitoba Health and provide your contact details.

Submitted by:  Loreley Fehr, Director, Health Services – Public Health-Healthy Living

As many of you are aware Southern Health-Santé Sud (SHSS) is participating in the Modernization and Provincial Standardization: Pathway to Long-Term Care (LTC) Project.   On February 18, Shared Health released a Provincial Clinical Practice Change with the updated Medical Assessment form for LTC.  

 Within SHSS we are undertaking a pilot project that will commence Monday, February 24, 2025to trial when the medical assessment is completed.  The previous process asked for redundant information from physicians to confirm medical stability and the level of professional interventions required for Personal Care Home (PCH) or supportive housing care. Much of that information lives already within the Home Care system with the Home Care Case Coordinator (HCCC).

The NEW form also focuses on CONTINUITY of CARE – what medical issues still need addressing (and their relevant history and physical findings) as the patient enters a PCH. For example, a handover from the primary care provider to the PCH provider as the patient enters their new home.

HCCC will now complete the application for PCH admission with families without a medical form for clients requesting a SHSS PCH. 

As we are the first region to test this process, the clients requesting a PCH outside of SHSS will require a medical form completed.

Once an individual reaches third from the top of the PCH waitlist, the PCH will trigger the medical completion in coordination with the Long-Term Care Access Coordinator.  The individual and families will receive communication along with a copy of the medical form and be asked to visit their primary care provider to have the medical form completed. For individuals residing in acute care awaiting placement the most responsible provider will be asked to complete the medical assessment when the bed has become available for the individual

The completed form will be sent back to our Long-Term care Access Coordinator for distribution to all preferred PCHs listed on the individual’s application. This medical assessment will be valid for six (6) months.

In an effort to close the loop in communication, once an individual is admitted to a PCH the primary care provider will be notified in writing by the PCH to advise their patient has been admitted and medical care of the patient has been assumed by the PCH provider. This will allow the primary care provider to de-enroll the individual from their home clinic.

More detailed information will be sent to the primary care providers directly as well.

Any questions about the change in process can be directed to any of the project team including Debbie Harms, Marianne Woods, Kelly Kaleta, Kaleigh Balboa, Dr. Rusk or Dr. Gosselin.

Submitted by:  Stephanie Rozsa, Interim Regional Lead – Community & Continuing Care

Please be advised the following monographs have been updated on the Drug Monographs page. For IV Parenteral Drug Manual holders, please add/replace/discard as indicated.

REPLACE ADULT Monograph:
Discard the old monograph, PRINT (using the hyperlink) & replace with the new monograph in the Adult Parenteral Drug Monograph Manual as listed below:

Submitted by: Cécile Dumesnil, Manager – Pharmacy
For more info. contact: 204-371-5952 or

All single ingredient Timolol eye drops are on backorder and stock will deplete prior to its return.

Timolol 0.25%, 0.25% XE, 0.5%, 0.5% XE
Alternative glaucoma eye drops with beta blockers remain available:

• Betaxolol 0.25%
• Latanoprost 0.005% / Timolol 0.5%
• Travoprost 0.004% / Timolol 0.5%
• Brimonidine 0.2% / Timolol 0.5%
• Dorzolamide 2% / Timolol 0.5%
• Brinzalomide 1% / Timolol 0.5%

Pharmacists will need to contact prescribers to determine the most suitable alternative. Details regarding depletion of inventory will be communicated on a site-specific basis.

Thank you for your support of the ongoing efforts to manage drug supply issues.

For questions, please contact your site pharmacy or:

Rizwan Ahmed or Libby Gair

Submitted by: Rizwan Ahmed, Director of Pharmacy & Libby Gair, Drug Distribution Supervisor

A provincial backorder alert for 40 mEq Potassium Chloride in 5% Dextrose and 9% Sodium Chloride 1000mL IV bags (see below) is expected to resolve by March, 2025. SH-SS expects to have stock available to last until the end of Feb, 2025.


BACKORDER: SH-SS SKU 01091
SOLN KCL 40MMOL 5%DEX
0.9%NACL 1000ML
Baxter Product Code: 2B2454X
Supplied: 15EA/CA

In an ongoing effort to mitigate supply disruption, Supply Chain Management-Shared Services (SCMSS) Value Analysis along with Shared Health Pharmacy Clinical Staff, have identified the following **ALTERNATE options:
**Clinicians are encouraged to select ALTERNATE IV solutions, based on the clinical status of the patient

SH-SS clinical staff use SKU #s below for ordering:

Access the print version to post for staff as needed.

Submitted by: Tamara Burnham, Collaborative Practice Lead