e-learning – Fever in under 5s
This guideline has been updated in Nov 19. It was first published in 2007, then updated in 2013, when I first did this blog. The main update this year is around Kawasaki disease. It used to be that Ka...
Louise Hudman is a GP locum and regularly summarises clinical guidelines, most of which now include an NASGP AppraisalAid e-Learning template, so you'll receive a pdf and Word document of your reflected learning.
e-learning | Rivaroxaban for preventing atherothrombotic events
This is a new guideline from NICE advising that rivaroxaban plus aspirin can be used in the prevention of atherothrombotic events, under certain circumstances. It was published in Oct 19. This is quit...
e-learning | Hypertension in adults
This is an updated guideline from NICE on managing hypertension in adults. It was published in Aug 2019. So what is new? The meat and bones of management is the same. There are a few small differences...
e-learning | Diagnosis and management of pneumonia
NICE first published guidance on pneumonia in 2014, and updated 2019. At that time there was a push to use the CRB65 score in general practice and also CRP as an aid to deciding on when to use antibio...
Dapagliflozin with insulin for patients with Type 1 Diabetes
This is a new guideline from NICE on using dapagliflozin in patients with Type 1 diabetes. It was published in Aug 19. Key learning points for me:There is a rise in the risk of ketoacidosis. It need...
e-learning | Management of hyperparathyroidism and high calcium
This is a new guideline from NICE on managing high calcium (Ca) levels and hyperparathyroidism. It was published in May 19. I am doing a general summary of the guideline. Although some of this is goin...
e-learning | Ertugliflozin in type 2 diabetes and the other SGLT-2 inhibitors
This is a new guideline from NICE giving advice on ertugliflozin, published in April 2019. I am also doing a quick reminder about the other SGLT-2 inhibitors. What is ertugliflozin? It is another sodi...
e-learning | Investigating patients with a raised ferritin
This is a guideline from the BSH on investigating and managing a raised ferritin. It was published in 2018. I'm going to summarise it, but there is a lot more in the guideline, which would be useful t...
e-learning | Managing abnormal liver function tests
This is a guideline on managing abnormal LFT that was published in 2017 by the British Society of Gastroenterology, but as it so useful I thought it worth summarising it. Key learning points for me:...
Stroke and TIA – initial management
This is an updated guideline from NICE on the management of stroke and TIA in over 16s. It was first published in 2008 and this update is from May 19. The most important change for us in this guidelin...
e-Learning | COPD – antibiotic prescribing in an acute exacerbation
This is a new guideline from NICE on when to prescribe antibiotics in an acute exacerbation. It was published in Dec 18. It should be read alongside their updated guideline on COPD. The most interesti...
e-Learning | COPD diagnosis and management
This is an updated guideline from NICE on the diagnosis and management of COPD, published in Dec 18. It's a pretty mammoth guideline, first written in 2004. There is a useful flow chart on management....
e-Learning | Management of Polycythaemia Vera
This is an updated guideline on the diagnosis and management of polycythaemia vera (PV) from the British Society for Haematology. It was published in Nov 18. PV is the same as polycythaemia rubra vera...
Intrauterine ball – a new copper intrauterine device
This is a 'New Product Review' from the FSRH on the intrauterine ball (IUB). It is otherwise known by the not so catchy title of SCu300B MIDI. This is a copper intrauterine device. It has copper beads...
e-Learning | Coughs (of the acute kind) and antimicrobial prescribing
This is a new guideline from NICE on when to prescribe antibiotics for coughs. It only covers those with acute coughs and doesn't include COPD patients (they are covered in a separate guideline). I w...
e-Learning | Ectopic pregnancy and miscarriage
This is an updated guideline on ectopic pregnancy and miscarriage from NICE (published Apr 19). It was last updated in 2012 when I originally wrote this blog post. The 2019 update doesn't add very muc...
e-Learning | Alcohol exposure prenatally and its effects on children and young people
This is a guideline on Fetal Alcohol Spectrum Disorder from SIGN outlining the assessment and management of children who have had prenatal alcohol exposure (PAE). It was published in Jan 2019. Prenata...
e-Learning | Lower urinary tract infection (UTI)
NICE released new guidelines in Oct 18 on antimicrobial prescribing in lower urinary tract infection (UTI). Public Health England (PHE) has guidelines on the diagnosis and management of UTI, which wer...
Podcast | I’m a GeriGP
NASGP member Eva Kalmus describes how she became co-chair of the new GeriGP group of the British Geriatrics Society (BGS), and why being a portfolio GP has never been boring. When I did my GP training...
e-Learning | Renal and ureteric kidney stones
This is a new guideline from NICE on managing renal and ureteric stones, published in Jan 19. I'll give a summary of what is new, then do a more detailed summary below. What is new in this guideline? ...
FSRH | Levosert – a levonorgestrel intrauterine device (LNG-IUS)
×Updated March 2019 This is a new product review from the FSRH. Levosert is an LNG-IUS, which is the same as Mirena. It seems to be as effective as Mirena and to have similar side-effects. It i...
e-Learning | Combined hormonal contraception guidelines from FSRH
This is an update from the FSRH on the use of combined hormonal contraception (CHC). There are a couple of elements in here that are new. I shall list these, then give the check-list of what they thin...
e-Learning | Post-traumatic stress disorder (PTSD)
This is an updated guideline from NICE on Post-Traumatic Stress Disorder PTSD. The last guideline came out in 2005. I don't think this really changes our management much (i.e. watch and wait for 1 mon...
Bronchial thermoplasty for severe asthma
This is a new guideline on bronchial thermoplasty from NICE on bronchial thermoplasty for severe asthma. NICE advise that it can be used.This procedure reduces the smooth muscle mass lining th...
e-Learning | Contraception in the over 40s
This was an updated guideline from the FSRH on contraception in the over 40s. It came out in Nov 17, but as it is so useful, I thought it worth doing a summary. There were a few things that were new f...
iFuse for chronic sacroiliac pain
This is a new guideline from NICE advising that iFUSE can be used for treating chronic sacroiliac pain. The guideline was released in Oct 18. It is worth being aware of as we may have patients affecte...
e-Learning | Chronic Heart Failure in adults
This is an updated guideline on heart failure from NICE published in September 2018. Most of this is what we are currently doing. They have pulled several different guidelines together to make this mo...
Management of pancreatitis
This is a new guideline from NICE on pancreatitis from Sep 2018. Most of it is aimed at secondary care, but there are a few things that are useful for us which I've outlined below. Advice to give pati...
Transurethral steam ablation for lower urinary tract symptoms in men
This is a new guideline from NICE recommending that transurethral water vapour ablation can be used for treating lower urinary tract symptoms (LUTS) in men. It was published in Aug 18. This procedure ...
Valproate – contraindicated in women of childbearing potential
You have probably heard about this on the news, or seen it in other forms, but in case you have missed it, I felt it important to do an update. This information came out in Apr 18 from MHRA. Valproate...
e-Learning | Management of dementia
Join the clinical conversation NASGP's GP-only Facebook GroupThis is a new guideline from NICE on the management of dementia. Most of this is not new, but there were a couple of things I wasn't ...
Prostate artery embolisation for benign prostatic hypertrophy BPH
This is guideline from NICE advises that prostate artery embolisation can be used as a treatment for lower urinary tract symptoms association with benign prostatic hypertrophy (BPH). This came out in ...
Podcast | A viper’s nest: when venom is a man’s best friend
Did you know that captopril was derived from the venom of the deadly Brazilian pit viper? Since it went on the market in 1981 captopril and its successor ACE inhibitors have probably saved many more l...
e-Learning | Bladder Pain Syndrome (Interstitial Cystitis)
This is a new guideline from RCOG on Bladder Pain Syndrome, which used to be called Interstitial Cystitis, among other things. As this is a new guideline and it is a common problem (affecting up to 6%...
Bisphosphonates, raloxifene and teriparatide for treating osteoporosis
This summary is based on 3 recent NICE guidelines:Bisphosphonates in people for primary or secondary prevention. Raloxifene for primary prevention. Basically it isn't advised. Raloxifene and teripar...
Hearing loss and ear wax
This is a new guideline from NICE on managing hearing loss and ear wax, published in June 2018. Exciting? Well, there are a couple of good bits in here, especially given how common a problem this is. ...
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 mo...
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 n...
Nice Attention Deficit Hyperactivity Disorder ADHD guideline
This is a guideline from NICE on Attention Deficit Hyperactivity Disorder ADHD. It was written in 2008, then updated in March 2018. The changes are relatively subtle, so I shall outline the changes, t...
Kyleena – a new intrauterine system for contraception
This is a statement from Jan 18, updated Mar 19, from FSRH giving information about Kyleena, which is a new levonorgestrel (LNG) containing intrauterine system (IUS). What is Kyleena? An IUS. It conta...