Shoulder dislocation management with associated fractures
The Anterior shoulder dislocation management page has been updated with guidance about management in cases with associated fractures.
Updates
IV morphine vs IV paracetamol for sciatica
The Paracetamol page has been updated with information about the superiority of IV morphine over IV paracetamol (alone) in patients with sciatica. Serinken, M, Eken, C, Gungor, F, et al. Comparison of Intravenous Morphine Versus Paracetamol in Sciatica: A Randomized Placebo Controlled Trial. Academic Emergency Medicine 2016;23(6):674-78.
Limitations of RCTs
The Analysis of the medical literature page has been updated with some additional information about the limitation of RCTs.
Silent MI
The Clinical assessment of suspected ACS page has been updated with additional information about the incidence of silent ischaemia. Incidence and Prognostic Significance of Silent Myocardial Infarction in the Atherosclerosis Risk in Communities (ARIC) Study. Circulation 2016;133(22):2141-8.
sBP target for ICH is < 180mmHg
The Stroke management page has been revised to indicate that the target sBP value for the management of primary ICH is < 180mmHg and that reductions to 110-140mmHg appear to confer no additional benefit. Qureshi, AI, Palesch, YY, Barsan, WG, et al. Intensive Blood-Pressure Lowering in Patients with Acute Cerebral Hemorrhage. N Engl J Med 2016.
Post bone marrow transplant AKI
AKI has been added as a complication to the Bone marrow transplantation page. Hingorani, S. Renal Complications of Hematopoietic-Cell Transplantation. New England Journal of Medicine 2016;374(23):2256-67.
Hungry bone syndrome
Hungry bone syndrome has been added to the Hypocalcaemia page as a cause of hypocalcaemia, hypophosphataemia, hypomagnesaemia and hyperkalaemia
Ticagrelor for stroke prevention
The Cerebrovascular disease page has been updated with information about the equivalence of ticagrelor and aspirin for the prevention of stroke. Johnston, SC, Amarenco, P, Albers, GW, et al. Ticagrelor versus Aspirin in Acute Stroke or Transient Ischemic Attack. New England Journal of Medicine;2016.
Sleeping, feeding and pooing in children
The Assessment of children page has been updated with additional information about the things little babies do best (see above) following the publication of the following review article: Goldstein, H, Tagg, A, Davis, T, et al. Baby steps: Understanding normal baby behaviour. Emerg Med Australas 2016;28(2):130-2.
GTC abnormalities
The Electronic fetal monitoring in labour page has been updated with some additional information about GTG monitoring, in particular adding CTG that usually require immediate action.
Management of sepsis
The Assessment of sepsis and Management of sepsis pages have had a few minor modifications following the publication of the following review (which was more theoretical than clinical). Gotts, JE, Matthay, MA. Sepsis: pathophysiology and clinical management. BMJ 2016;353:i1585.
Metastatic spinal cord compression
The Low back pain page has been updated with a segment on metastatic spinal cord compression following the recent publication of Al-Qurainy, R, Collis, E. Metastatic spinal cord compression: diagnosis and management. BMJ 2016:i2539.
Low back pain
The Low back pain page has been revised including a clearer explanation of the indications for surgery.
Idiopathic pulmonary fibrosis
A short segment on Idiopathic pulmonary fibrosis has been added to the Pulmonary fibrosis page.
Drug induced psychosis
The Psychosis page has been revised including the addition of a table of features that may help differentiate drug induced psychosis from psychosis due to schizophrenia. Glasner-Edwards, S, Mooney, LJ. Methamphetamine psychosis: epidemiology and management. CNS Drugs 2014;28(12):1115-26.
Metacarpal fractures
The Hand injuries page has been updated with a revised section on metacarpal fracture management. In particular, the lack of evidence of benefit from surgical management of most metacarpal fractures has been re-emphasised. Neumeister, MW, Webb, K, McKenna, K. Non-surgical management of metacarpal fractures. Clin Plast Surg 2014;41(3):451-61. Sletten, IN, Hellund, JC, Olsen, B, et … Read more
Ethnicity as a VTE risk factor
Ethnicity has been added as a risk factor for VTE to the Deep venous thrombosis page. Liao, S, McAnulty, K, Lim, C, et al. Ethnicity as an independent predictive factor for the results of CT pulmonary angiography and ultrasonography of the lower limbs. Internal Medicine Journal 2016:n/a-n/a.
May-Thurner syndrome
The Deep venous thrombosis page has been updated with a segment on May-Thurner syndrome, estimated to cause 2-5% of DVTs. Lee, AI, Ochoa Chaar, CI. The Hidden Lesion. N Engl J Med 2016;374(22):2160-65.
Seizures in pregnancy
The Seizures page has been updated with a segment on seizures in pregnancy. Kinney, MO, Morrow, J. Epilepsy in pregnancy. BMJ 2016:i2880
Falls
The Aging page has been updated with additional information about the epidemiology and assessment of falls, including the timed up and go test. Vieira, ER, Palmer, RC, Chaves, PH. Prevention of falls in older people living in the community. BMJ 2016;353:i1419.