Guideline for Management of Severe Asymptomatic Hypertension in Urgent Care

Author: Dr Gustav Fourie

2019

Abstract:

Hypertension is a common presentation but there is no New Zealand based guideline for the management of severe asymptomatic hypertension (greater than 180 systolic or 110 diastolic) in urgent care. Definitions have varied in both naming ( hypertensive emergency, hypertensive urgency, hypertensive crisis ,malignant hypertension,accelerated hypertension, severe asymptomatic hypertension) and parameters.

Method:

A review of recent literature was conducted.

Rivaroxaban as bridging agent for suspected DVT

Author: Dr Gary Mitchell

Abstract:

Rivaroxaban is well established as a treatment for deep vein thrombosis and pulmonary embolism, but there has been hesitation in using it as a bridging agent in clinical situations where DVT is suspected but not yet confirmed by definitive ultrasound scan. The evidence for the safety and efficacy of this approach is explored. During this time of research, the use of rivaroxaban began to gain acceptance and usage in New Zealand, leading to a brief analysis of factors involved in trying to introduce up to date guidelines into a small health organisation in New Zealand prior to widespread acceptance and definitive guidelines at District Health Board level.

Diverticulitis: the role of antibiotics in urgent care

Diverticulitis: the role of antibiotics in urgent care

Author: Dr Eleri Clissold

Abstract:

Our understanding of this common and painful disease is evolving. What was thought to be a predominantly infective process is postulated to be inflammatory and self-limiting in the majority of cases. Over several decades multiple high quality studies have emerged questioning the role of antibiotics in the management of acute diverticulitis without perforation, sepsis or other complications. No study has demonstrated the superiority of any antibiotic strategy in any one of multiple outcomes assessed. This literature search seeks to examine the evidence in-depth and place it in context for urgent care practitioners.