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S Heart, Lung and CirculationAbstracts S159 2011;20S:S156-S251 incentive survey with 65 multichoice questions covering all aspects of the service (indications, contraindications, image settings, safety, echo lab workforce and workflow issues and clinical relevance). These answers and a free text option were analysed to assess the program and to determine whether this survey method may be an adequate quality control measure. This survey was approved by the hospital's Human Research Ethics Committee.Results: Of the 54 staff invited to participate, 31 (55%) responded. Ninety-seven percent agreed contrast can improve image quality and improve assessment for LV non compaction (93%), LV thrombus (93%), LV morphology (90%), enhance spectral Doppler signals (70%) and RV function (44%). Seventy-four percent reported contrast results altered patient management. Eighty-two percent reported it increased confidence in echocardiographic findings. However, 60% felt contrast echo slowed down workflow through the department.Conclusion: The online survey technique proved an effective and efficient method to obtain, organise and interpret data in those who did respond. The 55% response rate was disappointing but higher than usual for comparable surveys (10%). The contrast program was interpreted positively with a high level of general knowledge and clinical relevance. Constructive feedback centred on disseminating the technique and recommendations to improve workflow through the department.

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OBJECTIVES: To compare the length of wean and abstinence severity in neonatal and pediatric patients with neonatal abstinence syndrome or iatrogenic opioid dependence treated with a pharmacist-managed, methadone-based protocol compared with physician-managed patients treated with either methadone or dilute tincture of opium (DTO). METHODS: This was a prospective, single-centered, interventional evaluation of 54 pharmacist-managed patients versus 53 retrospective, physician-managed patients. Wean duration and severity of neonatal abstinence syndrome were compared between groups using the Student t test. RESULTS: Significantly shorter wean duration in in utero-exposed pharmacist-managed patients compared with patients on physician-managed DTO (11.7 days vs 24.2 days, p < 0.001), but not compared with patients on physician-managed methadone (11.7 days vs 47 days, p = 0.101). No statistically significant difference was seen in wean duration in iatrogenic-exposed pharmacist-managed patients compared with patients on either physician-managed DTO or methadone (8.69 days vs 14 days, p = 0.096) and (8.69 days vs 9.82 days, p = 0.34), respectively. There were significantly fewer abstinence scores >12 in pharmacist-managed patients versus physician-managed DTO, but not physician-managed methadone (2.05 vs 17.3, p = 0.008 and 2.05 vs 74.3, p = 0.119, respectively). Significantly fewer abstinence scores ≥8 × 3 consecutively were seen in pharmacist-managed patients compared with patients on either physician-managed DTO or methadone (2.89 vs 11.9, p = 0.01 and 2.89 vs 24, p < 0.001, respectively). CONCLUSIONS: Use of a pharmacist-managed, methadone-based weaning protocol standardizes patient care and has the potential to decrease abstinence severity and shorten duration of wean versus physician-managed patients exposed to opioids in utero. Additionally, a methadone wean of 10% to 20% per day was well tolerated in both neonatal and pediatric patients.