Aldonga ED Tutes and Tips

Home » 2013 » April

Monthly Archives: April 2013

Difficult airways – remember ‘THE VORTEX’

Following on from teaching this week – follow the link for more information on  ‘the Vortex’.

A new ‘algorithm’ for managing an airway during RSI for managing unanticipated difficult airway.

vortex image

From The Vortex Approach by Nicholas Chrimes and Peter Fritz

Influenza H7N9 – 2013

Follow the link to this recent communication from the Chief Health Officer about the most recent ‘man flu’.

H7N9 image

Chief Health Officer Circular – H7N9 Influenza 9 April 2013

I’ve summarised the document as follows.

H7N9 should be suspected in anyone presenting to ED with symptoms consistent with influenza or community acquired pneumonia who has travelled to China or had contact with someone confirmed or suspected as having H7N9 IN THE LAST 7 DAYS.

Please take some time to read the attached document about H7N9 influenza – the most recent pathological strain to emerge.

It seem to have come from China and is associated with and genetically similar to previous H7 strains to have come from poultry.

There is limited data at this stage. It seems to have caused a high incidence of fatality (interestingly the strain causes little clinical symptoms in chickens and birds and this has caused difficulties in identifying it).

There is no apparent human-human transmission but the usual droplet precautions should be observed for anyone suspected of having influenza.

The document outlines investigation and treatment (laboratory studies confirm its susceptibility to oseltamivir – NOT confirmed in patients but recommended).


Also – a timely reminder to get your Flu vaccine if you haven’t already. Although this strain has no vaccine currently – who knows if it may provide some protection? Below is an excerpt from the Influenza Specialist Group website outlining the strains included this year for Australia:


The influenza vaccine for the Australian 2013 influenza season contains the following three virus strains:1, 2

  • A (H1N1): an A/California/7/2009 (H1N1) – like strain, 15 µg HA per dose
  • A (H3N2): an A/Victoria/361/2011 (H3N2) – like strain, 15 µg HA per dose
  • B: a B/Wisconsin/1/2010 – like strain, 15 µg HA per dose