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TheJournal Politics / Twitter. @campaignforleo launching new national clinical guidelines at Dublin Castle this morning pic.twitter.com/BRx69ksDum
— TheJournal Politics (@TJ_Politics) November 26, 2014
THE DEATH OF Savita Halappanavar and other people in Irish hospitals has led to the introduction of new guidelines.
The Minister for Health, Leo Varadkar, launched three new National Clinical Guidelines today. The three guidelines were recommended by HIQA following the tragic death of Ms Halappanavar.
“I think that the case of Savita Halappanavar and her unnecessary death does show us exactly what happens when sepsis is not detected soon enough and treated soon enough, and the experience of that case and unfortunately other cases too did feed into these guidelines,” Varadkar told reporters at the launch.
Guidelines
The guidelines were commissioned by the National Clinical Effectiveness Committee (NCEC) working in partnership with the HSE Clinical Programmes, expert clinicians, regulatory bodies, postgraduate training bodies, private hospitals and patients.
They are based on “best available research and are developed using an internationally recognised process”.
The guidelines are to be used “in conjunction with clinical judgement and patient preference when making decisions about what is appropriate for each patient or population of patients”.
The three guidelines being launched today were quality assured by NCEC and were subject to international peer review.
Varadkar noted that sepsis is the 10th leading cause of death worldwide. He said that “the management of severe sepsis and septic shock are considered a time-dependent medical emergency”.
Patient representative Linda Dillon said:
For the loved ones of any patient that has passed away from sepsis to now know that with the National Clinical Guideline – Sepsis Management in place there will be a greater chance of early pick up and therefore recovery will, I am sure, bring great comfort.
Early Warning System
The Irish Maternity Early Warning System (IMEWS) is a standardised bedside tool developed for use in maternity care to assess “basic maternal physiological parameters”.
The clinical handover guideline provides a structured communication tool to promote standardisation of clinical handover practice.
The three guidelines form part of a suite of National Clinical Guidelines published by the Department of Health and are mandated for implementation across the entire Irish health service.
The Minister for Health said that the “whole point of national standards is to raise everyone up to the highest standards”.
And we’ve already seen in some hospitals where the implementation of the early warning score has resulted in a decrease of people actually getting a cardiac arrest while they were in hospital, so this is important stuff. It may seem very technical but actually it raises standards and saves lives.
Additional reporting by Hugh O’Connell
Originally published: 5.24pm
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Few years ago, South Dublin hospital. I had an incredible pain and letter from my GP. 4 doctors couldn’t find what was wrong with me. I suggested I had a kidney stones problem, a very long time ago. Doctors gave me pain killers and asked me to rest at home. After 3 days of pain I went to a private clinic and asked about screening. I had 2 kidney stones, 6mm each in both kidneys-one of them blocked kidney and it could be a critical danger to me. I think we need real doctors-not supernumeraries.
Oh my god that’s so similar to what happened Savita. You are just so lucky that you have some kind of super power that allows you diagnose yourself without any tests, how dare those doctors not take your word for it.
Good work Leo and HSE. What happened Savita was tragic and hopefully these new measures should go a long way in making sure situations like her’s do not happen again.
That took long enough. What were they doing?
It takes a long time to write guidelines.- gathering evidence and consulting relevant professionals. It can’t be done too quickly if you want them to be good.
The whole apparatus of procedures in the HSE which exist for the benefit of it`s personnel, means that the patients come last, and are expendable.
Good work Leo. And not a mention of abortion! Savita and her family were used despicably by those advocating abortion! For shame! May she now rest in peace.
It didn’t stop the journal giving this story a not-too-subtle bump though
What do you reckon the avenue for infection was?
I mean, she essentially had a direct route to her internal organs nestled right beside where E. Coli live.
Us women have to be careful at the best of times – tampons carry a risk of toxic shock if left in for too long. And wiping back to front is never a good idea.
So do you think it would be a good idea to leave a woman with a dilated cervix for longer than necessary? If you have already diagnosed a miscarriage – what’s the hold up?
I’ll agree with you on one thing, this should never have been about abortion. In other countries when this happens the woman is told the risks of continuing the pregnancy and given the choice in whether she wants to be induced or let nature take its course. Savita requested a termination. She requested that our hospitals follow best practice. It was our “pro life” laws that prevented them from doing so.
It was our “pro life” laws that left the woman with the equivalent of a deep flesh wound beside the anus, without so much as a plaster on it for more than 24 hours.
That was in the report. Our laws prevented best practice from being followed. You can’t get around that no matter how hard you try.
I’ve seen 7 stories get a bump today. All different topics. You seem to think it’s a conspiracy.
No matter how hard I try? What age ARE you?
@Shanti
Savita’s death was caused not by Irish law but by staff incompetence, i.e. they thought that the lack of heating was why she was shivering. Tania McCabe also died of sepsis but nobody said that her death was caused by Irish law.
Some doctors and nurses are idiots. Look at how Dhara Kivlehan’s husband and the parents of the babies who died in Portlaoise hospital were treated.
Shanti… still won’t accept that you were wrong. The few pro-choice commentators on here all day prove how little yea care about the woman and her treatment. She doesn’t fit the bill anymore so she’s dropped like a hot potato. Nice of yea.
What on earth are you talking about Daniel? Savita has not been forgotten. And the amendment tabled to deal with situations like hers (that where a miscarriage is already in progress it should be aided medically – as is best medical practice) was struck down.
Sepsis management of course needed to be addressed – but the situation of actively promoting the circumstances where sepsis can occur? No. Our law still says that until the foetal heartbeat had stopped, the doctors have a duty to “protect the unborn”, so they cannot legally hasten the inevitable as Savita requested. They must leave the woman open to infection and then treat said infection should it occur.
Can you not see the sheer futility of that action? Why not allow the woman to decide whether she is willing to risk sepsis for the miniscule chance that she won’t miscarry? I mean, many will choose to take that risk. Far more than would opt to terminate, why not permit doctors to act in line with best medical practice if that is what the patient wants?
This is actually about maternal care – because when it comes to that in Ireland, women are frequently denied agency in many aspects of maternal care.
This is not about pro choice vs pro life, this is about a situation that needlessly puts the woman’s life at risk when a miscarriage is already in progress.
No, the law did not kill her. Sepsis and the failure to diagnose it killed her. The law already allowed for abortion where the mother’s life was in danger
Silver.
Why was her life in danger?
Did she have sepsis when she presented with the miscarriage? I doubt it, because sepsis works fast, and she didn’t die for another few days.
In most countries where they base medical decisions on evidence rather than ideology, once her membranes were ruptured and cervix dilated, they would have explained the risks to her (eg, this is a massive risk factor for sepsis) and asked her was she willing to take that risk. Otherwise the goal would have been to get the cervix closed again and that involves delivery.
She wasn’t willing to take that risk. We know that. She asked them to do what clinical evidence says you should. But the “undue focus on the foetal heartbeat” prevented the doctors from following best practice. And that is a direct effect of our law.
It’s the equivalent of not dressing a really deep flesh wound and that would be considered negligence.
Are you willfully ignoring that part for some reason?
You can have all the tools and training in place but they not gonna workout staff….
Not gonna work without staff!!
Already in use in many hospitals however the bright sparks in the HSE developed this in a complete silo from the National Early Warning System and therefore there are differences in the system not only the parameters, just to add to the confusion!
You’re so right it’s not about pro abortion or pro life. Until it was hijacked! The misrepresentation of the Savita case is undeniable and properly ousted by its absence from this report.
Well it was “hijacked” because the choice in what she should do was stolen from her. This is a wider issue within reproductive and maternal care. Women frequently are denied agency due to the doctors focus on the foetus.. I mean, women are denied the choice of homebirth, they’re pushed into courses of action they did not want – and that includes when they’re having the baby.
See, that’s why it’s called pro choice. Because we support women making their own choices, including giving birth and how they do so. We don’t advocate everyone aborting that would be silly, but we do speak out when women are denied agency over their own bodies.
Savita asked our doctors to do what any other country would have suggested she do for safety, and they told her they couldn’t.
Our country has a poor track record on its treatment of pregnant women. This is merely part of that.
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