Look alike ampoules
Dr Jane Torrie (ADHB) has brought the formulation of PHARMAC’s replacement Suxamethonium ampoules to our attention.  The 2ml glass ampoule is similar in presentation to many other common ampoules in our drug locker (see photos); including fentanyl 100mcg, tramadol, 8mg dexamethasone, metoclopramide, and ondansetron.

This change increases the likelihood of accidental drug swaps and the potential for devastating episodes of awareness. 

We have contacted PHARMAC over this issue and are looking for ways to help mitigate this circumstance. The prefilled suxamethonium syringes are available and are being used in some hospitals, but the supply of this is not infinite and the cost several times higher than either the plastic or glass ampoules.

Statement on senior medical workforce and COVID-19
The NZSA is a member of a newly established alliance “the COVID-19 Critical Care Collaborative” to advance COVID-19 critical care through advocacy and guidance on models of care. The other member organisations are:  ANZCA, the Australian Society of Anaesthetists, the Australian and New Zealand Intensive Care Society, the College of Intensive Care of Australia and New Zealand, and the Australasian College of Emergency Medicine. The group has recently released a statement: “Managing the senior medical workforce in intensive care during the COVID-19 pandemic.” 

PPE webinar
On 6 April the NZSA took part in a webinar with Dr Nick Coatsworth, Australia’s Deputy Chief Medical Officer responsible for issues relating to personal protective equipment (PPE). The Australian Society of Anaesthetists, ANZCA, the College of Intensive Care Medicine and the Australian and New Zealand Intensive Care Society also participated in this webinar. A recording can be viewed here

COVID-19 News
The Ministry of Health has information for health professionals with advice, guidelines and the latest news on COVID-19 on its website
We recommend this as your go-to key source. For COVID-19 resources such as articles and guidelines, visit the NZSA COVID-19 webpage – we are updating this regularly.

Advice on Ibuprofen use in COVID-19 patients
There is some confusion around the suggestion that NSAID’s, specifically ibuprofen, may predispose individuals to increased morbidity and mortality should they contract COVID19. An advisory has been developed by Auckland City Hospital to clarify the situation.

Waiving recertification requirements during COVID-19 pandemic
Throughout the COVID-19 pandemic, doctors are likely to have difficulties accessing the usual channels to undertake learning to meet recertification requirements.  There will be significantly reduced opportunities for CME. Council has therefore agreed to waive recertification requirements for the next 11 months.

Medicinal cannabis scheme

From 1 April, with the exception of Sativex, all medicinal cannabis products available in the immediate future will be unapproved medicines – i.e. they will not have consent for distribution under the Medicines Act 1981. Prescribers should be familiar with the requirements for prescribing unapproved medicines and Medsafe guidance on the topic. Current suppliers of Medicinal Cannabis Products will have until 1 October 2020 to submit their existing product for an assessment against the medicinal cannabis quality standard. Once an unapproved medicinal cannabis product has been assessed by the Medicinal Cannabis Agency as meeting the quality standards, all medical practitioners will be able to prescribe that product. Ministerial approval and specialist recommendation will not be required. A list of medicinal cannabis products which meet the quality standard will be made available to prescribers and other healthcare professionals.

Implicit bias in healthcare
Learning modules on explicit and implicit bias in healthcare have been released by the Health Quality and Safety Commission. HQSC’s medical director Dr Iwona Stolarek says that it can be confronting and challenging as a clinician to accept that you might not treat all your patients equally. The modules encourage health professionals to examine their biases, and how they affect the healthcare they provide and interactions with patients. Watch here