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Recent Posts by Louise Hudman

Stop smoking intervention

This is a new guideline from NICE on stop smoking interventions. If you do nothing else, I would strongly encourage you to do the National Centre for Smoking Cessation and Training NCSCT e-learning module on offering very brief advice to smokers. It only takes 10 minutes and is excellent. NICE advises that we use the…
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Heavy menstrual bleeding (menorrhagia)

NICE published an update to its guideline on heavy menstrual bleeding (menorrhagia) in March 2018. There are a couple of changes: Hysteroscopy is now the first line investigation for most women who need investigating for heavy menstrual bleeding, rather than ultrasound. There is no mention of age '45' now. In the old menorrhagia guideline, being…
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Otitis Media – when to use antibiotics

This is a new guideline from NICE on when to use antibiotics for otitis media (March 2018). It doesn't change common practice, but I found some of the statistics really helpful for explaining why we prescribe in some groups and not others. There is an excellent patient leaflet explaining things too. Some background info: Most have…
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Faltering growth in children

This is a recent guideline from NICE, which gives advice on managing faltering growth in children. A lot of this is common sense, but as it is a new guideline, I will summarise the bits relevant to us. I will not deal with weight loss in the first few days, as this is generally managed…
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Sore throat – when to use antibiotics

This is a new guideline from NICE which advises on when to use antibiotics in patients with tonsillitis or sore throat. If you already use a scoring system to help you decide when to prescribe it doesn't change a lot. Take home points: use a scoring system (FeverPAIN or Centor) and prescribe penicillin 500mg QDS…
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Diagnosing and managing cystic fibrosis

This is a new guideline from NICE on diagnosing and managing cystic fibrosis. Most of this guideline will be much more relevant to secondary care, so I'm just covering the list of possible presentations (as I'd forgotten quite a lot of these) and also some of the different mucolytic treatments (as I was not aware…
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Sinusitis treatment down to five days

This is a NICE guideline from a couple of months ago in the use of antibiotics in sinusitis. I must say that this has changed my practice significantly, so well worth a read, especially the background information. Main learning points: 1st line antibiotic is now penicillin. Length of treatment is five days. Only consider antibiotics…
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