Dunn RJ
Details of the Canadian syncope risk score have been added to the Syncope page following the publication of the article: Thiruganasambandamoorthy, V, Kwong, K, Wells, GA, et al. Development of the Canadian Syncope Risk Score to predict serious adverse events after emergency department assessment of syncope. CMAJ 2016;188(12):E289-98.
The Post arrest care page has been updated with a short segment on what should be looked for on a post arrest ECG.
The Airway management in obesity page has been updated with additional information about drugs that should be dosed based on ideal body weight or total body weight. Links to this information have been added to the Obesity and Paediatric cardiac arrest pages.
A segment on the Broselow tape system has been added to the Paediatric cardiac arrest page.
The segment on paediatric weight calculation on the Paediatric cardiac arrest page has had a major revision with multiple additional methods of weight estimation added.
The Prevention of secondary brain injury page has been updated with information about the outcomes from decompressive craniectomy following head trauma. Hutchinson, PJ, Kolias, AG, Timofeev, IS, et al. Trial of Decompressive Craniectomy for Traumatic Intracranial Hypertension. N Engl J Med 2016.
The Assessment of hypovolaemia page has been updated with a variety of changes indicating the likelihood of fluid responsiveness following the publication of the following article: Bentzer, P, Griesdale, DE, Boyd, J, et al. Will This Hemodynamically Unstable Patient Respond to a Bolus of Intravenous Fluids? JAMA 2016;316(12):1298-309.
The Advanced cardiac life support page has been updated with additional criteria for the cessation of CPR in non-shockable rhythms. Jabre, P, Bougouin, W, Dumas, F, et al. Early Identification of Patients With Out-of-Hospital Cardiac Arrest With No Chance of Survival and Consideration for Organ Donation. Annals of Internal Medicine 2016.
An image of IO access in the humeral head has been added to the Difficult intravenous access page.
The Pericardial tamponade page has been updated with information about the US measurement of pulsus paradoxicus. Thanks to Thiru Govindan for the information.
The Central venous access page has been updated with information about management of inadvertent arterial puncture.
The Post arrest care page has been updated with additional information about ICH and the role of CT in survivors who make it to hospital.
The Anaesthetic risk page has been updated with additional information about pre-operative testing and risk of miscarriage related to surgery.
Just in case you were wondering, an irregularly irregular pulse has an LR+ of 25 for AFib.
The Bradycardias and Other arrhythmias pages have been updated with the requirement for p waves to be present in heart block. The absence of p waves means the bradycardia is either junctional or idioventricular (although retrograde p waves may still be seen in junctional rhythms).
The Electrical cardioversion page has been updated with clearer guidance on the minimum paddle pressure that should be applied.
The Ventricular arrhythmias page has been updated with additional information about drugs that may increase the QTc. QT interval and drug therapy. BMJ 2016;353
A video clip demonstrating poor LV function has been added to the Cardiac output measurement page.
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.
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.