ECMO
The Mechanical cardiovascular support page has been updated with some minor additions to the segment on ECMO.
Updates
Intracavity haemostatic foam
A short segment on intracavity haemostatic foam has been added to the Management of the trauma patient page.
Vascular access in trauma
The Management of the trauma patient page has been updated with a new segment on Vascular access in trauma.
Partial REBOA
A new segment on partial REBOA has been added to the Management of the trauma patient page.
Surgical repair of ankle ligament injuries
The Soft tissue injuries of the ankle and foot page has been updated with the indications for operative repair of grade 3 ligamentous injuries around the ankle.
Examination of suspected pelvic fracture
The Assessment of pelvic trauma page has been updated with revised information about the physical examination – in particular emphasising that pelvic springing should not be performed in patients suspected of unstable pelvic fractures due to the risk of causing further bleeding.
Pelvic fracture definitive management
A segment on the definitive management of pelvic fractures has been added to the Management of pelvic trauma page.
Pelvic fracture management
The Management of pelvic trauma page has been revised and updated.
Penetrating colonic injuries
Some additional information about the management of penetrating colonic injuries has been added to the Penetrating trauma to the trunk page.
Metronidazole toxicity
Additional details about the neurotoxicity of metronidazole have been added to the Anaerobic cover page.
Metformin in renal impairment
The Other hypoglycaemic agents page has been updated with more specific information about the use of metformin in patients with renal impairment.
Management of incidental ovarian cysts
The Ovarian cysts page has been updated with additional information about the management of incidentally discovered ovarian cysts based on their imaging characteristics.
NSAIDs for ureteric colic
The Renal calculi page has been updated with additional information about the efficacy of NSAIDs in renal colic, particularly IM diclofenac. Pathan, SA, Mitra, B, Straney, LD, et al. Delivering safe and effective analgesia for management of renal colic in the emergency department: a double-blind, multigroup, randomised controlled trial. The Lancet.
US for ureteric colic
The Loin pain page has been updated with additional information including the technique to visualise ureteric calculi with US.
Pre PCI beta blockers
The Management of acute coronary syndromes page has been updated with additional information about the role of pre-PCI beta blockers. Roolvink, V, Ibanez, B, Ottervanger, JP, et al. Early Administration of intravenous Beta blockers in patients with ST-elevation myocardial infarction before primary PCI. Journal of the American College of Cardiology 2016.
Myoglobin in ACS
The Other cardiac biomarkers page has been updated with additional information about the role of myoglobin in excluding ACS in low risk patients. Meek, R, Braitberg, G, Cullen, L, et al. Outcome at 30 days for low-risk chest pain patients assessed using an accelerated diagnostic pathway in the emergency department. Emerg Med Australas 2016.
Risk stratification for ACS in patients < 40 years of age
The Risk stratification in suspected ACS page has been updated with additional information about the characterstics of patients with ACS who are < 40 years of age.
Inferior MI ECG changes
The ECG in acute coronary syndromes page has been updated with additional information about determining which artery is likely the source of the culprit lesion in inferior MI.
Ulcer size increases rebleeding risk
The Upper GI haemorrhage page has been updated and the size of the ulcer added as a risk factor for rebleeding. Camus, M, Jensen, DM, Kovacs, TO, et al. Independent risk factors of 30-day outcomes in 1264 patients with peptic ulcer bleeding in the USA: large ulcers do worse. Alimentary Pharmacology & Therapeutics 2016:n/a-n/a. . … Read more
Early second shock in in-hospital cardiac arrest
The Advanced cardiac life support page has been revised to increase the emphasis on the utility of an early second shock in in-hospital cardiac arrest. Bradley, SM, Liu, W, Chan, PS, et al. Defibrillation time intervals and outcomes of cardiac arrest in hospital: retrospective cohort study from Get With The Guidelines-Resuscitation registry. BMJ 2016:i1653.