Drug Consult

For evaluation of a comprehensive, evidence based response to a clinical question.

Presenter: Ashley P Question Answered: Epoprostenol for anticoagulation in CRRT

1 2 3 4
Below Basic Requirements Approaching Basic Requirements Meets Basic Requirements Exceeds Basic Requirements
o Speaker was ineffective and o Speaker was usually effective and o Speaker was effective and consistent. o Speaker was outstanding in
inconsistent. Speaker exhibited consistent. Speaker exhibited Speaker exhibited knowledge and/or effectiveness and consistency.
knowledge and/or skills below knowledge and/or skills at a level skills at a competent level that was Speaker exhibited knowledge and/or
minimum competency. not always on par with peers. on par with peers. skills well above minimum
competency.

Outcome Score Comments

Communication: 1 2 3 4 Yes, clear and audible.
 Vocal: audible, articulate, appropriate rate.
 Lack of distracting vocal mannerisms (“uh,” “um”, etc.) I like the figure included.
 Physical: good eye contact. Eye contact NA
Style: 1 2 3 4 Through voice alone, speaker was
 Presents material in self-assured manner. confident and interested in the topic.
 Exhibits interest and/or enthusiasm for topic.
Organization: 1 2 3 4 Yes, easy to follow – challenging
 Presentation is well organized, easy to follow. during this webex online format.
Would consider using the “Page
 Handout and/or audiovisuals complement Width” view version so the share
presentation. screen text is wider, easier to read
Content: 1 2 3 4 Do we use heparin in CRRT? What is
 Pertinent background information provided. our normal practice for
 Pertinent patient information included or N/A (circle) anticoagulation in CRRT?
Presented pertinent literature
 Thoroughly researched all biomedical literature related
to the question. 1st study: Unclear how patients
 Literature is critically evaluated. started on epoprostenol plus/minus
 Discusses patient-specific therapeutic considerations. heparin? How was it decided?
 Concludes with own recommendations based on
2nd study: Again, would have liked to
analysis of literature.
know more detail, How was it chosen
 Information is accurate and well-referenced. those who received epoprostenol?
Everyone started on the
 Answers questions logically and accurately. epoprostenol and heparin added if
not anticoagulated? Or other ADR?
Additional Comments:
Very nice review of CRRT and the use of the citrate. Also clearly explained why we can be looking for an alternative anticoagulant (post
filter and measured Ca levels inconsistencies/discrepancies). Since I did not know anything about citrate, epoprostenol, and heparin in
CRRT, it would have been nice to have a table of these products and their use in CRRT (and ECLS since that seems to be common as
well). Would have liked some info on our current practices at VCH, have we used it here? Would have liked another table of these 3
agents, use, dose, ADR, monitoring, study results, comments. Are there other studies? Or these are the only 3 out there?
I think this is very interesting and could warrant some more discussion and prep in the future. Since this question has come up once
now, I wouldn’t be surprised if the ICU wanted to do this soon and then started asking about doses, etc. It would be best for us to
have some answers prepared. I will save this for a future DC for someone…or you can consider for the future.

Evaluator:_______Wenee____________________________ Date:____8.27.2020______________