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 539, 19 June 2019 - How to correctly dose frusemide and why ABGs are still useful

Clinical Update 538, 29 May 2019 - Propofol and unscheduled procedural sedation - new Guidelines and recommendations

Clinical Update 537, 15 May 2019 - Stroke - extending the window with imaging v time based reperfusion. A good theory pity about the evidence - the EXTEND trial and others

Clinical Update 536, 1 May 2019 - Not so fast - urgency of cardioversion in new onset AF and timing of post arrest cath if NSTEMI

Clinical Update 535, 17 April 2019 - Workup for pulmonary embolus in pregnancy. Two new studies and coroners cases

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