Neer IIb Xray
An Xray of a Neer IIb distal clavicular fracture has been added to the Shoulder and arm region injuries page.
Bob Dunn
Tonsillar herniation MRI
An MRI demonstrating tonsillar herniation has been added to the Imaging features of raised intracranial pressure page.
MRI of cerebellar infarction
An MRI demonstrating a cerebellar infarct has been added to the Stroke syndromes page.
Dense basilar artery sign
A plain CT image demonstrating a dense basilar artery sign has been added to the Stroke syndromes page.
CXR in ACS
A short segment on the utility of routine CXR in patients with ACS has been added to the Management of acute coronary syndromes page.
Absent IUP and adnexal mass on TVUS
The test characteristics of an absent IUP and adnexal mass on TVUS have been added to the Abnormal vaginal bleeding page.
Testicular torsion
Some additional information about testicular torsion has been added to the Scrotal emergencies page.
Arterial blood gas collection technique
Some additional information about the technique of collection of an arterial blood gas has been added to the Arterial access page.
Dental abscesses
Some additional information about dental abscesses has been added to the Odontogenic pain page, with particular reference to the important role of drainage and lack of utility of antibiotics with or without drainage.
Cauda equina MRI
The Lower back pain page has been updated with an MRI image of cauda equina syndrome.
Cauda equina additions
The Lower back pain page has been updated with additional information about the diagnosis of cauda equina syndrome.
Cauda equina CT
The Lower back pain page has been updated with a CT image of cauda equina.
Icatibant in ACE induced angioedema
Some additional information about the efficacy of icatibant in patients with ACE induced angioedema has been added to the Angioedema page. Bas, M, Greve, J, Stelter, K, et al. A randomized trial of icatibant in ACE-inhibitor-induced angioedema. N Engl J Med 2015;372(5):418-25. http://www.ncbi.nlm.nih.gov/pubmed/25629740.
Stop using IV glucagon for oesophageal foreign bodies
The Gastrointestinal foreign bodies page has been revised to more actively discourage the use of IV glucagon, which has little evidence of effect and potential adverse effects. BET 1: use of glucagon for oesophageal food bolus impaction. Emergency Medicine Journal 2015;32(1):85-88. http://emj.bmj.com/content/32/1/85.2.abstract.
Medical expulsive therapy for calculi 5-10mm diameter
The section on medical expulsive therapy on the Renal calculi page has been revised to include the potential benefit of MET in stones 5-10mm in diameter. Furyk, JS, Chu, K, Banks, C, et al. Distal Ureteric Stones and Tamsulosin: A Double-Blind, Placebo-Controlled, Randomized, Multicenter Trial. Annals of Emergency Medicine http://dx.doi.org/10.1016/j.annemergmed.2015.06.001.
Vasopressors through peripheral IV lines
The Central venous access page has been updated with information about the relative safety of the use of vasopressors through peripheral IV lines. Brewer, JM, Puskarich, Michael A, Jones, Alan E. Can Vasopressors Safely Be Administered Through Peripheral Intravenous Catheters Compared With Central Venous Catheters? Annals of Emergency Medicine http://dx.doi.org/10.1016/j.annemergmed.2015.05.026.
US guidance for subclavian CVC insertion
The Central venous access technique page has been revised to now recommend the use of dynamic US for subclavian CVC insertion. Kim, JL, Koyfman, A. Does Ultrasonographic Guidance Reduce Failure Rates and Adverse Events for Subclavian Vein Catheterization Compared With the Landmark Technique? Annals of Emergency Medicine http://dx.doi.org/10.1016/j.annemergmed.2015.07.001.
Edoxaban and other NOAC updates
Some additional information about Edoxaban has been added to the Other anticoagulants page (although it is not licensed in Australia and does not appear to have any advantage over rivaroxaban or apixaban), as well as a variety of small changes to information about the other NOACs. A good recent open access review article on the subject … Read more
Time to reduction for shoulder dislocation
A small addition outlining the importance of minimising time to reduction for anterior shoulder dislocations has been added to the Glenohumeral joint dislocation page.
Steroids for severe CAP
The Management of CAP page has been updated with information about the beneficial role of steroids in hospitalised patients with severe CAP. Siemieniuk, RAC, Meade, MO, Alonso-Coello, P, et al. Corticosteroid Therapy for Patients Hospitalized With Community-Acquired Pneumonia. A Systematic Review and Meta-analysis. Annals of Internal Medicine 2015.