Lyme disease
The Lyme disease page has been updated with some additional information following the NEJM review article on the subject published today.
Updates
Arterial insufficiency in venous thrombosis
A segment on arterial insufficiency secondary to extensive venous thrombosis has been added to the Deep venous thrombosis page.
Using the EJV to measure venous pressure
A small section on using the IJV to estimate venous pressure has been added to the Cardiovascular examination page.
Infectious gastroenteritis
The Infectious gastroenteritis page has been extensively revised including a more comprehensive section on assessment and management.
Management of missile injuries
The Missile injuries page has been updated with a small segment on the management of missile wounds.
Damage control laparotomy
The Management of the trauma patient page has been updated with a segment on damage control laparotomy.
Anti viral agents in influenza
The Influenza page has been updated to reflect the new evidence that indicates anti viral agents are less effective in the treatment of influenza than previously thought, reducing illness duration by only 14 – 17 hours and having little effect on rates of pneumonia or hospitalisation. Add these to the long list of drugs shown to be … Read more
Thrombolysis in intermediate risk PE
The Management of PE page has been updated to reflect the lack of benefit and excess of adverse effects in patients with intermediate risk PE (echocardiographic changes without hypotension) treated with thrombolysis compared to placebo which was reported in a trial just published in the NEJM.,
Investigation of anaemia
A large section on the investigation of anaemia has been added to the Anaemia page.
Bee stings
The Insect envenomation page has been updated with some additional information about bee stings.
Advanced airway techniques and chest compressions
The Basic life support page has been updated to emphasise that advanced airway techniques, when performed quickly, improve the effectiveness of chest compression. This is probably due to improved co-ordination between chest compression and ventilation.
Water temperature and immersion time in drowning
The Drowning page has been updated with a reduction in the emphasis on water temperature and an increase in the importance of immersion time as factors in the prognosis following drowning.
Packed cell transfusion strategy and infection
The Packed cell transfusion page has been updated with information about the 5% (absolute) increase in infection risk associated with a liberal transfusion strategy (Hb > 9g/dL) compared to a more restrictive strategy.
High flow nasal cannula therapy
The Oxygen therapy page has been updated with information about high flow nasal cannula therapy, used in infants and as apnoeic oxygenation prior to intubation.
ACEM policy statement on thrombolysis in stroke
The Thrombolytic therapy in stroke page has been updated to incorporate ACEM’s revised statement on the subject updated in March 2014 that states: “ACEM recognises intravenous thrombolysis as a potentially beneficial intervention for acute ischaemic stroke. There is however, conflicting evidence such that the administration of stroke thrombolysis by ED staff is a controversial area and cannot currently … Read more
Management of sepsis without SvO2 or CVP measurement
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.
EDACS accelerated diagnostic protocol for suspected ACS
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.
Haemolytic anaemia FBE
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!).
Fe deficiency anaemia FBE
An FBE of a patient with iron deficiency anaemia has been added to the Microcytic anaemia page.
Erythrocytosis FBE example
An FBE of a patient with erythrocytosis has been added to the Myeloproliferative disorders page.