Archives for October 2011

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How good is BIS? Does it prevent awareness?

OK, for those of you who are not practicing Anaesthetics this might be a bit boring, but it is an intriguing look at the way an idea can become entrenched in the medical psyche, even if the evidence doesn’t really support it. BIS (electroencephalogram-derived bispectral index) is a monitor, applied usually to the patient’s forehead […]

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2011 Guidelines : what’s new in Acute Coronary Syndromes

This is a summary of the new ACS guidelines – hot off the press. Heart, Lung and Circulation has produced the 2011 Addendum to the National Heart Foundation of Australia/Cardiac Society of Australia and New Zealand Guidelines for the Management of Acute Coronary Syndromes (ACS) 2006. There are a few new concepts and changes which will effect the […]

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Medical mythology: Antibiotics for C-section – when?

This clinical question comes from Dr Tim (KI Docs). He got talking to some specialist O&G and Anaesthesia docs about the timing of prophylactic ABs for LUSCS.  Doesn’t ssound too controversial – but it is one of those ‘memes’ of medicine that persist even well after the evidence is in and accounted for with clear […]

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Managing Traumatic bleeding: how can we apply the evidence in smaller hospitals?

OK after Clinical Case 031 I was inspired to go out and slog through the literature and try to discover what is “best practice” for traumatic bleeding, then try and work out what is important, what we can do in small or remote hospitals and what is just too expensive / difficult / marginal or plain […]

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Clinical Case 031: Big transfusion, Little Hospital = big trouble

I have been working on a post dealing with massive transfusion – Broome style – for a while now.  So last week we landed in a tricky situation.  My colleague had taken a chap with a splenic rupture to theatre and used a good volume or red cells – depleting our small blood bank, when […]