Updates – Page 127 – The Emergency Medicine Manual

Repeat ECGs in suspected ACS

17/10/2018 by Bob Dunn

The ECG in ACS page has been updated, including additional information about the diagnostic yield from repeat ECGs.

Clinical assessment of ACS

17/10/2018 by Bob Dunn

The Clinical assessment of ACS page has had a number of minor improvements, including a better description of the role of clinical assessment.

Aortic dissection prognosis

17/10/2018 by Bob Dunn

The Thoracic aortic dissection page has been updated, including additional information about the prognosis of aortic dissection.

4th universal definition of MI

17/10/2018 by Bob Dunn

The Definition of AMI page has been updated with the 2018 definition of MI – importantly including new ECG criteria for STEMI that differ according to the leads used, age and gender of the patient.

hsTn and risk scores for ACS

17/10/2018 by Bob Dunn

The Risk stratification in ACS page has been updated, including a short segment outlining the issues with using risk scores in association with hsTn.

Syncope and PE

17/10/2018 by Bob Dunn

The Syncope page has had a few minor changes, including a statement that PE is an uncommon cause of syncope in ED patients.

Aminocaproic acid removal

17/10/2018 by Bob Dunn

Aminocaproic acid has been removed from a variety of parts of the book as it is no longer available in Australia or New Zealand. Thanks to Stephanie for the suggestion.

Pneumothorax size measurement

09/10/2018 by Bob Dunn

The Assessment of pneumothorax page has been updated to indicate that the BTS guidelines recommend measurement of the separation of the lung from the chest wall at the level of the hilum on CXR.

Pneumothorax – correction

09/10/2018 by Bob Dunn

The Abnormal intrathoracic gas page has been updated, including removing traumatic causes from the section on primary pneumothorax. Thanks to Farzad for picking this up.

Venous HCO3 is higher than arterial HCO3 – correction

09/10/2018 by Bob Dunn

The Blood gas analysis page has been corrected to indicate that venous HCO3 is higher than arterial HCO3 (by about 1.7 mmol/L) – this was incorrect on one part of the page and correct in another.

Estimated total body iron deficit table

09/10/2018 by Bob Dunn

The Microcytic anaemia page has been updated, including the addition of an estimated total body iron deficit table.

Total body iron store replacement dose – correction

09/10/2018 by Bob Dunn

The Microcytic anaemia page has been corrected so the total body iron store replacement dose is now correct. It is: Total body iron deficit (mg) = body weight (kg) x (target Hb – actual Hb in g/L) x 0.24 + 500 mg For patients > 35 kg body weight.

Put the amputated part in a jar

04/10/2018 by Bob Dunn

The Digital amputations page has been updated with the recommendation to put amputated parts into a jar, rather than a plastic bag, before putting them in cold water or ice.

Nail bed laceration repair

04/10/2018 by Bob Dunn

The Nail injuries page has been updated, including clarification of the lack of need to remove an intact nail to determine if nail bed injury is present.

Adrenaline in digital blocks

04/10/2018 by Bob Dunn

The Regional anaesthesia page has been updated to reflect that lignocaine with adrenaline is safe for digital nerve blocks.

MRI of the shoulder

04/10/2018 by Bob Dunn

The Soft tissue injuries of the shoulder region has been updated to suggest that MRI is the investigation of choice for evaluation of suspected acute soft tissue injuries around the shoulder.