The provision of i.v. thrombolysis by cardiac nurse practitioners is safe and should be considered as a method for achieving acceptable door to needle times in the management of acute myocardial infarction.

Background Chronic shoulder pain is an increasing problem in the ageing population. For patients with inoperable problems, management of persistent pain is often inadequate with current non-operative measures. Suprascapular nerve (SSN) block and pulsed radiofrequency (RF) treatment of the SSN gives relief for up to 12 weeks. It is considered that continuous thermal radiofrequency treatment (CTRF) of the SSN may give longer pain relief. Methods Sixty-two patients with chronic shoulder pain were assessed for CTRF treatment of the SSN using a standard technique with a Neurotherm RF lesion generator under image intensification as a day case. Results The mean age of the patients was 74 years. The majority of patients had a significant rotator cuff lesion. Mean visual analogue scores scores fell significantly from 9.1 to 4.5 at 6 months following treatment (p = 0.0001) and 85% patients reported > 50% pain relief at 6 months. Half the patients reported an improvement in sleep and mobility. No serious adverse effects were reported. Conclusions CTRF to the SSN significantly reduced shoulder pain for up to 6 months without adverse effects and gave longer relief than pulsed RF or SSN block. It may be repeated with a similar effect being achieved. The limitations of the present study is the use of a medium-sized series with 6-month follow-up.