Principles of opioid therapy
A segment on the principles of opioid therapy has been added to the Opioids page, including a table of morphine milligram equivalent doses.
Updates
Normal echocardiographic measurements
The Echocardiography page has been updated with a reminder to interpret ‘normal’ echocardiographic measurements considering the body habitus and activity level of the patient. Many athletes have increased IVC, LV wall and aortic root diameter measurements.
Mesenteric ischaemia
The Mesenteric ischaemia page has been extensively revised following the publication of the following review article. Campion, EW, Clair, DG, Beach, JM. Mesenteric Ischemia. New England Journal of Medicine 2016;374(10):959-68.
Maxillary sinusitis
The Acute sinusitis page has been revised including the addition of the NNT of 20 for antibiotics in maxillary sinusitis.
Home use naloxone
The Opioid antagonist and partial agonists page has been updated with information about the recent decision to make naloxone available without prescription in Australia.
Status epilepticus
The Status epilepticus page has been updated including new information about the relative efficacy of different anti-convulsant agents.
Assessment of shock
The Assessment of shock page has been updated with a table indicating the approximate mortality rates associated with various degrees of hypotension in the ED.
Antifungal coverage for antibiotics in PD patients
The Peritoneal dialysis page has been updated with the recommendation that antifungal therapy is provided to patients on peritoneal dialysis who receive antibiotics for any indication, to prevent the development of fungal peritonitis.
Chronic kidney disease
The Chronic kidney disease page has been updated with additional emphasis on the ED management and Hb targets for erythropoietin therapy.
Pulse wave assessment
The Assessment of intravascular volume page has been updated with additional information about pulse wave assessment and CVP measurement in the assessment of hypovolaemia.
Massive transfusion score
The Treatment of hypovolaemia page has been updated with the addition of details about the Massive transfusion score (MTS) and revised MTS.
Deficit resolution in ICH
A statement about how approximately 0.5% of patients with ICH may have transient neurological deficits has been added to the Intracerebral haemorrhage page.
Propensity matched studies
A segment on propensity matched studies has been added to the Experimental design page.
ST elevation in gastric volvulus
The ECG in acute coronary syndromes page has been updated with gastric volvulus added to the possible caused of ST elevation.
Thiamine deficiency due to alcohol
The Ethanol page has been updated with information about the rarity of thiamine deficiency in the Australian population after thiamine supplementation of flour was introduced in 1991.
Umbilical cord clamping
The Normal labour & delivery page has been updated with information indicating that holding the baby at vaginal level whilst waiting to clamp the umbilical cord is no longer considered necessary. Fetal transfusion is unchanged by placing the baby on the mother’s stomach.
RBBB with RV pacing
The Complications of pacemakers page has been updated indicating that RBBB may still be normal in patients with RV pacing leads.
Oesophageal reflux management
The Oesophageal causes of chest pain page has been updated with additional management to prevent symptoms.
Hypomelanosis of Ito
The Phakomatoses page has been updated with a segment on Hypomelanosis of Ito.
Perimortem Caesarian section
The Advanced cardiac life support page has been updated with additional information about the technique of performing a perimortem Caesarian section following publication of the article: Parry, R, Asmussen, T, Smith, JE. Perimortem caesarean section. Emerg Med J 2015