Updates

The Management of sepsis page has been updated in light of recent evidence that suggests the frequent measurement of SvO2 or CVP does not appear to alter outcome in severe sepsis.

The Risk stratification in suspected ACS page has been updated with details of the very important Emergency Department assessment of chest pain score and associated accelerated diagnostic pathway recently published in EMA.

An FBE of a patient with haemolytic anaemia has been added to the Normochromic anaemia page, despite the patient having macrocytosis (thus elegantly demonstrating the limitations of the cell size classification system for anaemia!).

An FBE of a patient with iron deficiency anaemia has been added to the Microcytic anaemia page.

An FBE of a patient with erythrocytosis has been added to the Myeloproliferative disorders page.

The Myeloproliferative disorders page has been updated with new information about Erythrocytosis (formerly known as Polycythaemia rubra vera) following a recent BMJ review.

The Assessment and management of vertigo page has been updated following the NEJM review article just published on benign positional vertigo. It now includes great sounding treatments such as the ‘barbeque rotation’ and ‘Gufoni’s manoeuvre’.

A small segment on the possible role of the melatonin agonist, ramelteon in the prevention of delirium in the elderly has been added to the Altered mental state page.

The Investigation of suspected subarachnoid haemorrhage page has been updated following the publication of a systematic review of the subject in Annals of Emergency Medicine this week.

The Chemical burns page has been updated with additional information about the management of bitumen (tar) burns.

The Deep venous thrombosis page has been updated with the latest risk estimates for the different possible Modified Wells scores published in the BMJ. The original Wells score has been removed as is no longer considered useful.

The White blood cells page has been updated with additional information about lymphopenia and it’s causes.

The Termination of pregnancy page has been updated following a recent BMJ review of the subject.

The Serotonin toxicity page has been updated following the most recent BMJ article on the subject and now includes more explicit explanation of the Hunter diagnostic criteria.

The Osmolality page has been updated with an improved description of the difference between total osmolality and effective osmolality (tonicity).

The Hyponatraemia page has been extensively updated following the recently released European clinical practice guidelines on the assessment and management of hyponatraemia. There have been changes to the SIAD (previously known as SIADH) segment, definitions of acute vs chronic hyponatraemia and new recommendations for the use of 3% saline – and a whole lot more!

A number of updates have been made to the Pacemakers page including the things you should know about in a patient with a pacemaker and additional information about the actions of pacemaker magnets.

The Magnetic resonance imaging page has been updated with information regarding the types of MRIs that GPs can now order in Australia.

The DIsseminated intravascular coagulation page has been updated with the International Society for Haemostasis and Thrombosis DIC scoring scale.

A small segment outlining the cardiorespiratory changes that occur during labour has been added to the Labour & delivery page