A living WHO guideline on drugs for COVID-19

This living guideline responds to emerging evidence from randomised controlled trials (RCTs) on existing and new drug treatments for covid-19. More than 2800 trials on covid-19 interventions have been registered or are ongoing. Among these are large national and international platform trials (such as RECOVERY, WHO SOLIDARITY, and DISCOVERY) that recruit large numbers of patients, with a pragmatic and adaptive design. These platform trials are currently investigating and reporting on drugs such as antiviral monoclonal antibodies and immunomodulators. This rapidly evolving evidence landscape requires trustworthy interpretation and expeditious clinical practice guidelines to inform clinicians, patients, governments, ministries, and health administrators.

Priapism

 Non-ischemic (high-flow)Ischemic (low-flow)
Physical ExamTypically painless, not fully tumescentPainful, fully tumescent with corpus cavernosa rigidity without involvement of corpus spongiosum and glans penis
AetiologyHigh-flow priapism is extremely rare and most commonly associated with antecedent trauma including blunt trauma, or resulting from needle injury of the cavernosal artery.Low-flow priapism is caused by impaired relaxation and/or paralysis of cavernosal smooth muscle and in sickle-cell disease
ManagementNOT EmergencyEmergency
 
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A swallowed ‘timely’ emergency

A swallowed watch (button) battery can cause fatal perforation with mediastinitis if lodged in the oesophagus. The need to removed urgently under general anaesthesia makes this a ‘timely’ emergency.

ACLS REVISION: Post ROSC Care

Once we’ve achieved ROSC our job is not over. Good post-arrest care involves maintaining blood pressure and cerebral perfusion, adequate sedation, cooling and preventing hyperthermia, considering antiarrhythmic medications, optimization of tissue oxygen delivery while avoiding hyperoxia, getting patients to PCI who need it, and looking for and treating the underlying cause.

Kenya Emergency Medical Care Policy 2020-2030

The Kenya Emergency Medical Care (EMC) Policy 2020-2030 is the first-ever policy in Kenya that seeks to establish a working Emergency Medical Care (EMC) System as a key component of the healthcare system in the country. The policy also speaks to the World Health Assembly resolution WHA 72.16 of 21 May 2019 which urged member states to create policies for sustainable funding, effective governance and universal access to safe, high-quality, needs-based emergency care for all as part of universal health coverage. In developing this policy, the Ministry of Health (MOH) aims to ensure access to the highest standards of emergency medical care in Kenya as envisioned in The Constitution of Kenya (2010) and the Health Act (2017) which guarantees every Kenyan the right to emergency medical treatment.

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Community Health Workers in Emergency Care

CHWs have shown great efficacy in reducing mortality and morbidity associated with multiple disease categories and help to fill healthcare worker shortages worldwide. Utilising CHWs to provide emergency care in the community requires a focus on their formal training and can strengthen the emergency care system overall.

Emergency Hotlines

Emergency Hotlines establish a reliable fixed-line system that is able to improve emergency care and reduce mortality and morbidity through improved communication and collaboration with emergency care centres.