Iron Deficiency Anaemia
As we improve our preventative health screening practices in Remote Indigenous Health we inevitably encounter incidental abnormalities in routine pathology. Given our limited resources and developing recall systems, what do we do about them? The ABS report that remote indigenous populations are 2-3 times as likely to suffer from...
Medicare Cheat Sheet for ED
Glenn’s Medicare Cheat Sheet for ED Here is the updated version of the medicare cheat sheet (March 2018), mainly for working out of the Hospital Emergency department. It contains most of the numbers for the commonly billed items. We have these laminated and attached to the triage clip boards...
Incidental Eosinophilia
As we improve our preventative health screening practices in Remote Indigenous Health we inevitably encounter incidental abnormalities in routine pathology. Given our limited resources and developing recall systems, what do we do about them? Over the next few weeks we will address a handful of common queries and a...
Professional Burn Out – Am I Enough?
Behind every committed professional is the quietly disconcerting question “Am I enough?” Our profession is full of them; harm avoidant, reward dependent, goal orientated individuals. However in remote practice, these effective traits can lead to frustration and burn out. Supporting systems are still in development, recruitment and retention is...
Q. Is bed rest an effective treatment for anything?
Meta-analysis on 39 randomised control trials for 15 different conditions (5777 patients) Following a medical procedure: Out 24 RCTs-No outcomes improved significantly 8 worsened significantly in some procedures Lumbar puncture – vertigo, nausea and vomiting (no significant improvement in headache) Spinal anaesthesia – headache, back pain Radiculography – headache,...
What is the appropriate mode of delivery after a previous shoulder dystocia?
The rate of SD in women who have had a previous SD has been reported to be 10 times higher than the rate in the general population.There is a reported recurrence rate of SD of between 1% and 25%.May be an underestimate due to selection bias,as CS may...
Does induction of labour prevent shoulder dystocia?
Early IOL for women with suspected fetal macrosomia,who do not have gestational diabetes,does not improve either maternal or fetal outcome.(Evid level 4) In women with gestational diabetes, the incidence of SD is reduced with early IOL.(Evid level 2+) The NICE diabetes guideline recommends that pregnant women with diabetes who...
What dose Ketorolac?
Comparison of Intravenous Ketorolac at Three Single-Dose Regimens for Treating Acute Pain in the Emergency Department: A Randomized Controlled Trial Motov, Sergey et al. Annals of Emergency Medicine 2016 Dec. Study Design: N = 240, 18-65 years Randomised to receive 10mg, 15mg, 30mg IV ketorolac as single dose (double blinded)...
Even Short-term Oral Steroids Carry Serious Risk
Short term use of oral corticosteroids and related harms among adults in the United States: population based cohort study BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j1415 (Published 12 April 2017)Cite this as: BMJ 2017;357:j1415 Cohort study of more than 1.5 million adults 30 days of initiating these drugs, even at relatively low...
Should we be giving our women steroids prior to elective caesarean section?
Delivery by elective caesarean section at less than 39+0 weeks of gestation can lead to respiratory morbidity in neonates, requiring admission to the neonatal intensive care unit A recent retrospective cohort study showed that, compared with elective caesarean section births at 39+0 weeks of gestation, births at 37+0 weeks...