Accuracy of POC gases and lab values
The Specimen collection page has been updated, including the addition of a segment on the accuracy of POC blood gas measurement compared to formal laboratory measurement.
Clinical skills
Venous vs arterial lactate
The Metabolic acidosis page has been updated with important information about the level of agreement between arterial and venous lactate. Venous and arterial values should not be used interchangeably.
Domestic violence
The Domestic violence page has had a major revision including the addition of multiple areas aimed to provide practical advise.
Futile care
The Extent of medical treatment page has been updated with a section on futile care.
How to break the news of death
The Bereavement section has been updated, including a revised section on how to break the news of death.
How to ask for consent
A detailed guide on how to ask for consent has been added to the Consent page.
Communication
The Communication page has been updated, including additional information about overcoming barriers to communication. If you only ever read one page of the manual, read this one.
Approach to medical imaging
The General approach to medical imaging page has been updated with mostly changes to improve wording and clarity.
Iodinated contrast allergy
The Intravenous contrast page has been updated with some additional information about factors that do not increase the risk of contrast allergy.
ECG changes in hypokalaemia
The Ion effects on the ECG and Hypokalaemia pages have been updated with new information about ECG changes in hypokalaemia.
Euthanasia
The Extent of medical treatment page has had a few touch ups, including a short segment on euthanasia.
Hyperkalaemia
The Hyperkalaemia page has had an update, including the most common contributors in ED patients.
Discussing appropriate treatment
The Extent of medical treatment page has been revised with a substantially updated segment on substituted decision making.
Hypercalcaemia
The Hypercalcaemia page has been updated with mostly changes to improve clarity.
Calcium
The Calcium page has been updated, including some reorganisation and rewording to improve clarity.
Disclosing error
The Patient safety page has been updated with some additional information about how to disclose error following a patient safety incident.
Venous HCO3 is higher than arterial HCO3 – correction
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.
Serum lactate and Hartmann’s administration
The Metabolic acidosis page has been updated with some additional information about how large volumes of Hartmann’s solution may contribute to lactic acidosis. Zitek, T, Skaggs, ZD, Rahbar, A, et al. Does Intravenous Lactated Ringer’s Solution Raise Serum Lactate? J Emerg Med 2018
Lactic acidosis
The Metabolic acidosis page has been updated with some additional causes of lactic acidosis.
Patterns of LFT abnormality table
The table of patterns of LFT abnormality on the Liver function tests page has been extensively revised and updated.