Safe Nurse-Led Pre-CTCA Beta-Blockade Administration can be Achieved Without Intensive Medical Supervision

Adjustments to the standard oral Beta Blocker protocol always reect a reduction in the dosage. Protocol deviation is often used in patients where there is either not enough time from preparation to scanning time for the oral BB to take effect or in patients where we are cautious of excessive BB effects for a clinical reason. In these cases it is understandable that the use of IV BB is increased as the onset is quick and the half life is minutes rather than hours. Best care for everyone Jo.wickham@waitematadhb.govt.nz This table shows the standard oral BB dosage protocol (per heart rate in beats per minute) versus the actual dosage given. Highlighted boxes indicate where the standard protocol dose was administered. Nurse specialists play an important role in the delivery of CT coronary angiography (CTCA) in the acute chest pain setting. The appropriate dosing of oral and intravenous beta-blockers is crucial to achieve the required heart rate at time of scan of 60 bpm or less. A beta blocker dosing protocol was developed at North Shore Hospital as a guideline for prescription. Nurse specialists worked with the developed dosing protocol over 18 months and found that it was necessary, at times, to deviate from the protocol due to patient history, timing of the scan or ECG information to achieve a safe and effective scan.