In the past few months, several societies released guidelines concerning the treatment of cardiac and vascular conditions. By paying attention to these guidelines, CV leaders and practitioners can be assured they are implementing the best evidence-based practices available.
Below, we outline the most important takeaways from three new guidelines: updated treatments for peripheral artery disease and hypertension, as well as protocols for ICU admission, triage, and discharge.
Peripheral artery disease
The American Heart Association and American College of Cardiology recently released new guidelines for managing patients with lower extremity peripheral artery disease (PAD). The guidelines set standards for assessing and diagnosing PAD, including performing vascular examinations, noting that abnormal findings from a physical exam must be confirmed with diagnostic testing. The guidelines also establish standards for reporting ankle-brachial index (ABI) results and determining in which patients an ABI is indicated. Finally, the guidelines suggest treatment regimens—including lifestyle, medical, and procedural interventions— for PAD patients.
The Society of Critical Care Medicine also released guidelines for ICU admission, discharge, and triage based on evidence-based recommendations and best practices. When discussing ICU admission, the society advised against incorporating a 24/7 intensivist model if an organization staffs under a high-intensity model, in which an intensivist manages the patient daily but advanced providers provide supplemental support. During the triage process, the guidelines encourage emergency department clinicians to provide care in the ED if the ICU experiences overcrowding. Finally, they encourage the use of step-down units or a long-term acute hospital for discharged patients at-risk of readmission or mortality.