Analytical errors in biochemistry
The Interpretation of investigation results page has been updated with additional information about analytical errors.
Updates
Sodium measurement
The Hyponatraemia page has been simplified by the removal of reference to factors affecting [Na+] when using flame photometric or indirect ion sensing methods as these are rarely, if ever used in current practice.
Hypernatraemia
The Hypernatraemia page has had a number of other minor updates.
0.45% Saline replacement volume formula for hypernatraemia
The Hypernatraemia page has been updated with a formula for calculating the volume of 0.45% saline required to replace TBW deficits.
Free water deficit formula
The Hypernatraemia page has been updated with a more accurate free water deficit formula.
Hypophosphataemia
The Hypophosphataemia page has had a number of minor updates.
Normal serum phosphate levels
The Phosphate page has been updated with an expanded range of normal phosphate levels for different ages.
Transient synovitis
The Paediatric orthopaedic conditions page has been updated with some additional information about transient synovitis of the hip.
8.4% NaHCO3 for severe hyponatraemia
The Hyponatraemia page has been updated with information about the use of NaHCO3 for the treatment of severe hyponatraemia.
Osmotic demyelination syndrome
The Hyponatraemia page has been updated with additional information about osmotic demyelination syndrome.
Stroke prevention in AF
The Stroke prevention in atrial fibrillation page has had a number of other updates.
LAA occlusion in AF
The Stroke prevention in atrial fibrillation page has been updated with additional information about LAA occlusion.
Device detected AF
The Assessment of atrial fibrillation/flutter page has been updated with additional information about device detected AF.
Limitations of the CHA2DS2VA score
The Stroke prevention in atrial fibrillation page has been updated with additional information about the limitations of the CHA2DS2VA score.
CHA2DS2VA and stroke risk table
The table on the Stroke prevention in atrial fibrillation page previously demonstrating the CHA2DS2Vasc score and stroke risk has been updated to demonstrate the CHADS2VA score and stroke risk.
Atrial fibrillation stroke risk
The Stroke prevention in atrial fibrillation page has been updated with a revised segment on AF stroke risk.
Minimum O2 flow rate through a Hudson mask is 5L/min.
The Oxygen therapy page has been updated with expanded details on the minimum O2 flow rate through a Hudson face mask.
Blood gas calculations require PaCO2 or PaO2 values, not venous PCO2 or PO2 values
The Blood gasses page has been updated to better reflect that, if you are going to do calculations on blood gas results at all, you need to use arterial O2, CO2 and HCO3 values. Better still, learn something else that is less prone to error, better validated and more clinically useful…..
PaO2 and PaCO2
All instances of PO2 and PCO2 in the manual have been updated to PaO2 and PaCO2 whenever relevant to prevent readers thinking that PO2 and PCO2 may mean venous PO2 or PCO2.
Ensuring extent of neuromuscular paralysis is measured and reversed prior to extubation
The Endotracheal extubation page has been updated with additional emphasis on ensuring the extent of neuromuscular paralysis is measured and reversed prior to extubation. In particular, do not assume neuromuscular blockade will have worn off after a few hours in ED patients.