24/5/26 Diphtheria alert
There is currently an outbreak of Diphtheria in parts of the Northern Territory, Western Australia and South Australia. Please be alert for cases of oropharyngeal and cutaneous Diphtheria in patients who have been to these regions, particularly Indigenous patients.
Important copyright and AI information
Please be reminded that unauthorised reproduction of the Manual in any form, including creation of summaries, audio or animation, or copying content into any machine learning tool is not permitted. Breaches of this agreement will result in immediate, and permanent, termination of access and legal action for breach of copyright.
Dedication
This manual is dedicated to the memory of Dr Edward William Brentnall FACEM, MBE, OAM, KStJ 05/08/1929-01/10/2024. Ed was a guiding light for generations of emergency physicians who sheltered, mentored and inspired many of us. See the full dedication here.
Latest updates
Ensuring extent of neuromuscular paralysis is measured and reversed prior to extubation
The Endotracheal extubation page has been updated with additional emphasis on ensuring the extent of neuromuscular paralysis is measured and reversed prior to extubation. In particular, do not assume neuromuscular blockade will have worn off after a few hours in ED patients.
Duration of action of rocuronium
The Non depolarising neuromuscular blocking agents page has been updated with additional information about the duration of action of rocuronium, particularly emphasising it is highly variable and may be very significantly prolonged.
Beat to beat variation in QRS amplitude in AF
The Assessment of atrial fibrillation or flutter page has been updated with information about the beat to beat variation in QRS amplitude in AF,
Treatment of AF through an accessory pathway
The Supraventricular tachycardia page has been updated to better reflect the dangers of AV nodal blockade in AF through an accessory pathway.
Features of AFib through an accessory pathway
The Supraventricular tachycardia page has been updated with additional information about the features of AF through an accessory pathway.
Important correction : AFib and accessory pathway – ventricular rate often > 200bpm
The Supraventricular tachycardia page has had a significant correction. Previously it was stated that in AFib with an accessory pathway the ventricular rate was often < 200bpm, when it is actually commonly > 200bpm.
Activated charcoal
The Activated charcoal page has been revised and updated, including some changes to the indications and contra-indications.
Substance related seizures
The Substance induced seizures page has been revised and updated.
