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Netherlands Working Group on Intensive and Cardiac Care Unit

Testimonial from Dr Iwan C.C. van der Horst (Chairperson)

What are your main project/achievements?:

We are just starting a revival of the working group. In discussion with the national board we came to the conclusion that there is a high need for cardiologists that are capable of taking care of critically ill cardiac patients. This conclusion is primarily based on the changing population of patients presenting nowadays. The achievements made over the past years make that certain patients do surely better, but will present later on as a more complex cases. We are aware that it is our goal to give these patients the best possible care, therefore we must prepare for the future.

What are the main issues encountered in your country in the way of acute cardiovascular care disease are managed?:

  1. There are clear criteria how to take care of acute cardiovascular patients
    • European guidelines are very often implemented in daily care
      • The government is setting (safety) criteria to be met
      • The national society is actively involved in quality control of the great performance level of all individual groups of cardiologists in each hospital
    • Many cardiologists are involved in associations of the ESC and give their contribution to guidelines
  2. There is a solid collaboration between both individual hospitals and the ambulance services and between different hospitals
    • based on these collaborations there a networks working on ST elevation myocardial infarction, non ST elevation myocardial infarction, out of hospital cardiac arrest and acute heart failure/shock
    • clear pre-hospital protocols are already available
    • last year a very important initiative was launched for acute myocardial infarcton: nvvc!connect
    • the most recent initiative is on teaching all students in resuscitation: CRASH

What are the main gaps identified and how could that be solved?:

  • Getting insight into data, we sense a need for a national registry
    Solution: imputing data into the developed system (NCDR)
  • How to optimally treat cardiac patients at the intensive care unit
    Solution: cardiologist becoming cardio-intensivist, improving collaboration between cardiologists and intensivist
  • How to take care of cardiac patients with co-morbidity Solution: education, working together with other specialists
  • High quality protocols available in certain hospitals/areas Solution: open sources
  • Getting all cardiologists involved in acute cardiovascular care joining the working group (national/ACCA)
    Solutions: being visible on a local, regional and national level; serving the needs of individual cardiologists through education and scientific and case based meetings

What do you expect from your collaboration with ACCA/ESC?:

  1. keeping up to date
    • e-learning material (ESCel platform)
    • skills training (Medical/clinical & Scientific)
    • organizing meetings for getting informed on developments within different ESC countrie
  2. publishing guidelines for every field of acute cardiovascular care, reviewing the evidence and translating it to protocols to be implemented in daily care
  3. presenting all the initiatives over Europe so we learn from each other