EM Clinical Updates

Please note that these updates are a review of current literature and do not replace local treatment protocols and policy. Treating doctors are individually responsible for following standard of care.

Clinical Updates for 2019

Clinical Update 534, 3 April 2019 - Venous thromboembolic disease 2019 Australian Guidelines - Part 2

Clinical Update 533, 20 March 2019 - Venous thromboembolic disease 2019 Australian Guidelines - Part 1

Clinical Update 532, 6 March 2019 - When urgent cardiac cath isn't always the answer - Wellens pattern ST elevation in aVR with diffuse ST depression

Clinical Update 531, 20 February 2019 - Clinical decision rules for pariatric head injury - NEXUS II examined. The rules have problems.

Clinical Update 530, 6 February 2019 - Methotrexate for ectopic pregnancy - expect problems

Clinical Update 529, 23 January 2019 - Ventilation Strategies in non ARDS Patients - Low TV Strategies are Less Critical though Avoid High Plateau Pressures

Clinical Update 528, 9 January 2019 - Learning by Pictures

Clinical Updates for 2018

Clinical Update 527 - Year in Review Part 2

Clinical Update 526 - Year in Review Part 1

Clinical Update 525, 7 November 2018 - So you want to reverse a DOAC. Good luck.

Clinical Update 524, 24 October 2018 - Work up of fever in infants 0-90 days. The Step by Step Approach, and what about the LP.

Clinical Update 523, 10 October 2018 - Angioedema - adrenaline and steroids don't help, but a possible role for bradykinin antagonists

Clinical Update 522, 19 September 2018 - CT-coronary Angiogram. Implausble outcome benefits suggested, and still no reason to order from ED

Clinical Update 521, 5 September 2018 - Atrial Fibrillation - NHF Australia 2018 Guidelines. Some important changes.

Clinical Update 520, 22 August 2018 - Thunderclap Headache - its more than aneurysms, and LP is still part of the workup

Clinical Update 519, 8 August 2018 - Opiod prescribing in ED - there are alternatives

Clinical Update 518, 25 July 2018 - New stroke trials - WAKEUP, tPA in minor stroke, low dose tPA and dual antiplatelet therapy. Should practice change?

Clinical Update 517, 11 July 2018 - Syncope - new 2018 ESC Guidelines allow for risk stratification and potential early discharge from ED

Clinical Update 516, 27 June 2018 - Paediatric DKA - a major study on fluid administration debunks some myths

Clinical Update 515, 13 June 2018 - Brugada Syndrome - who needs an AICD, what to do with AF, and drugs to avoid

Clinical Update 514, 30 May 2018 - Sepsis Update. The new SSC 2018 1 hour bundle, and the limitations of evidence.

Clinical Update 513, 2 May 2018 - ACEP 2018 Clinical Policy on DVT-PE - maybe practice not as evidence based as we would like.

Clinical Update 512, 18 April 2018 - High flow nasal O2 in bronchiolitis - still hard to see a patient centred benefit in this new study.

Clinical Update 511, 28 March 2018 - AHA 2018 Stroke Guidelines - incorporating the DAWN and DEFUSE - 3 trials on delayed thrombectomy beyond 6 hours.

Clinical Update 510, 21 March 2018 - Fluids - maybe normal saline is not that normal, though not much in it. The SMART and SALT-ED trials

Clinical Update 509, 7 March 2018 - Sepsis Update - recognition is still not straightforward, and 2 studies on steroids give conflicting results

Clinical Update 508, 21 February 2018 - TB or not TB, and when it threatens the airway

Clinical Update 507, 7 February 2018 - Suicide risk assessment, and workup of the psychiatric patient aka medical clearance.

Clinical Update 506, 10 January 2018 - Lack or benefit of provocative testing for chest pain work up, no benefit of PCI in stable angina, and the ACEP STEMI Policy

Clinical Update 505, 3 January 2018 - Pictures to learn by - interesting imaging