Stiff person syndrome
A segment on Stiff person syndrome has been added to the Other movement disorders page.
Updates
Non fasting lipids are OK
The Cardiovascular risk reduction page has been updated with the recommendation that fasting for lipid sampling is no longer required. Mora, S. Nonfasting for routine lipid testing: From evidence to action. JAMA Internal Medicine 2016.
Paracetamol ingestion algorithm
The Paracetamol ingestion algorithm on the Paracetamol page has been updated with the expanded indications for oral activated charcoal contained in the September 2015 Australian management guidelines.
Paracetamol toxicity
Some minor revisions to the Paracetamol page have been made, including the NNT (7) for charcoal within 2 hours of ingestion.
Osteoid osteoma
The segment on Osteoid osteoma on the Bone tumours page has been revised.
Prazosin for PTSD
The Torture and trauma page has been updated to include the use of prazosin for patients with PTSD.
Exertional rhabdomyolysis
The Crush injury page has been updated with information about the benign nature of exercise induced rhabdomyloysis (without heat stroke).
Thoracic US in bronchiolitis
The Bronchiolitis page has been updated to include that multiple B lines may be found on thoracic US.
Anticoagulation in AF and ESRF
The Cerebrovascular disease page has been updated with revised information about anticoagulation for patients with AF and end stage renal failure. Dahal, K, Kunwar, S, Rijal, J, et al. Stroke, Major Bleeding, and Mortality Outcomes in Warfarin Users With Atrial Fibrillation and Chronic Kidney Disease: A Meta-Analysis of Observational Studies. Chest 2016;149(4):951-59.
Aspirin for TIA
The Cerebrovascular disease page has been updated with revised information about the effectiveness of aspirin for stroke prevention in patients with TIA.
MRI for appendicitis
The Appendicitis page has been updated with new test characteristics of MRI. Petkovska, I, Martin, DR, Covington, MF, et al. Accuracy of Unenhanced MR Imaging in the Detection of Acute Appendicitis: Single-Institution Clinical Performance Review. Radiology 2016;279(2):451-60.
Seizures and driving
The segment on seizures and driving restrictions on the Management of isolated seizures page has been updated with reference to the Austroads: Assessing fitness to drive publication.
Buprenorphine
Some additional information about buprenorphine has been added to the Opioid antagonists & partial antagonists page.
Tolerance, dependence and addiction
The Illicit drug use page has been revised including a better description of the differences between drug tolerance, dependence and addiction.
Management of withdrawal in patients on MATOD
Additional information about the management of opioid withdrawal in patients on medication assisted treatment for opioid dependence (MATOD) has been added to the Opioid antagonists & partial antagonists page.
Half strength apple juice for ORT
The Paediatric gastroenteritis page has been updated with information about the efficacy of half strength apple juice for ORT in children with only mild dehydration. Freedman, SB, Willan, AR, Boutis, K, et al. Effect of dilute apple juice and preferred fluids vs electrolyte maintenance solution on treatment failure among children with mild gastroenteritis: A randomized … Read more
Low dose tPA for stroke
Some information about low dose (0.6mg/kg) IV tPA for the treatment of stroke has been added to the Thrombolytic therapy in stroke page. Anderson, CS, Robinson, T, Lindley, RI, et al. Low-Dose versus Standard-Dose Intravenous Alteplase in Acute Ischemic Stroke. N Engl J Med 2016.
ACEM position on thrombolysis in stroke
Information regarding the position on ACEM on tPA for the treatment of stroke has been updated on the Thrombolytic therapy in stroke page.
Below knee DVT complication rates
The Management of DVT page has been updated with the rates of complications revised downwards from those previously quoted. Horner, D, Hogg, K, Body, R. Should we be looking for and treating isolated calf vein thrombosis? Emergency Medicine Journal 2016;33(6):431-37.
Don’t transfuse platelets to patients with ICH on antiplatelet agents
The Platelet transfusion and Stroke management pages have been updated with information from the PATCH RCT published in Lancet that demonstrated an increase in disability and mortality from platelet transfusion in patients with supratentorial ICH on mostly aspirin, clopidogrel and/or dipyridamole. The exact mechanism for this is unclear. Baharoglu, MI, Cordonnier, C, Salman, RA-S, et al. … Read more