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.
Bob Dunn
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.
Website problems – now resolved
Yesterday we had problems with the website – the navigation bars disappeared as did most of the update pages and access to the susbscribers accounts. Because of this we have had to wind back time and restore the site to a backup made at 03:00 on Monday 7/4/14. This has just been completed. What that … Read more
The Emergency Medicine Manual translated
A translation widget has been added to the front pages (i.e. not the whole content) of The Emergency Medicine Manual Online, enabling you to translate into 14 of the worlds most spoken languages (including Maori). Click on the “Translate” icon floating on the page, then choose the language to translate the page content into. No responsibility is taken for … Read more
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
Post arrest temperature management poll results
Comment Recent evidence suggests that cooling to 36C is as good as cooling to lower temperatures in patients with ROSC following cardiac arrest. However this still means that active temperature management is required and hyperthermia should definitely be avoided.
Table of contents page expansion
The main Table of contents page has been expanded to include links to some of the additional features available only in the online version of the manual. We have done this as a number of subscribers have been unaware that the online version also contains quizzes, calculators, image galleries and Journal scans. All existing links to these pages … 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.
Erythrocytosis
The Myeloproliferative disorders page has been updated with new information about Erythrocytosis (formerly known as Polycythaemia rubra vera) following a recent BMJ review.
Benign positional vertigo
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’.
Ramelteon and delirium
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.
CSF spectrophotometry for SAH
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.
Bitumen burns
The Chemical burns page has been updated with additional information about the management of bitumen (tar) burns.