Clinical Reference Centre

Clinical Management2 min read

Home Non-Invasive Ventilation: Selection and Monitoring

Home NIV supports selected patients with chronic ventilatory failure from neuromuscular disease, chest-wall disorders, obesity hypoventilation or COPD.

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Condition2 min read

Hospital-Acquired Pneumonia: Diagnosis and Antimicrobial Strategy

Hospital-acquired pneumonia develops after hospital admission and carries increased risk of resistant organisms and severe illness.

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Condition2 min read

Hyperkalaemia in Acute Care: Recognition and Treatment

Hyperkalaemia can cause fatal arrhythmia. Immediate assessment should include ECG monitoring, confirmation when appropriate, cardiac protection when indicated, intracellular shift and removal of potassium.

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Condition3 min read

Hyperkalaemia: Emergency Recognition and Management Principles

An updated guide to hyperkalaemia severity, ECG assessment, cardiac protection, intracellular shift, potassium removal and monitoring.

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Condition3 min read

Hypernatraemia: Assessment, Water Deficit and Safe Management

A clinical guide to hypernatraemia, water deficit, diabetes insipidus, sodium gain, correction rates and monitoring.

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Condition2 min read

Hyperosmolar Hyperglycaemic State: Recognition and Management

Hyperosmolar hyperglycaemic state causes profound dehydration, severe hyperglycaemia and hyperosmolality, often with limited ketonaemia.

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Condition2 min read

Hypertension in Adults: Diagnosis, Treatment and Monitoring

Hypertension diagnosis should be confirmed with ambulatory or home blood-pressure monitoring when appropriate. Management combines cardiovascular risk assessment, lifestyle intervention and stepwise medication.

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Condition2 min read

Hypertensive Emergency: Target-Organ Injury and Controlled Reduction

Hypertensive emergency is severe blood-pressure elevation with acute target-organ injury. The diagnosis depends on organ damage, not the blood-pressure number alone.

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Condition2 min read

Hyperthyroidism: Diagnosis, Cause and Treatment Options

Hyperthyroidism may result from Graves disease, toxic nodular disease or thyroiditis.

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Condition2 min read

Hypertrophic Cardiomyopathy: Diagnosis and Sudden-Death Risk

Hypertrophic cardiomyopathy is unexplained increased left ventricular wall thickness with diverse genetic and clinical expression. Assessment includes symptoms, obstruction, fibrosis, arrhythmia and family history.

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Condition2 min read

Hypoglycaemia in Diabetes: Recognition, Treatment and Prevention

Hypoglycaemia can impair cognition, cause seizures or coma and limit safe glucose-lowering treatment.

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Condition3 min read

Hypokalaemia: Assessment, Replacement and Clinical Risk

A clinical reference to potassium loss, redistribution, magnesium deficiency, ECG risk and safe replacement.

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Condition2 min read

Hyponatraemia in Acute Care: Symptoms, Tonicity and Safe Correction

Acute-care assessment of hyponatraemia begins with neurological severity, tonicity, glucose and likely duration. Severe symptoms require protocol-led hypertonic therapy and close monitoring.

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Condition3 min read

Hyponatraemia: Diagnostic Assessment and Safe Correction

An evidence-informed guide to hypotonic hyponatraemia, symptom severity, SIADH, volume assessment and prevention of overcorrection.

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Condition2 min read

Hypovolaemic Shock: Recognition and Resuscitation

Hypovolaemic shock results from loss of blood or other intravascular volume. Control haemorrhage, restore circulation, prevent hypothermia and identify ongoing loss.

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Condition2 min read

Idiopathic Pulmonary Fibrosis: Diagnosis, Antifibrotic Therapy and Monitoring

Idiopathic pulmonary fibrosis is a progressive fibrosing interstitial pneumonia diagnosed through multidisciplinary integration of clinical and radiological findings.

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Clinical Reference2 min read

Immune Thrombocytopenia

Diagnose ITP after excluding secondary causes and treat according to bleeding, platelet count, comorbidity, procedures and patient preference.

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Condition2 min read

Infective Endocarditis: Recognition, Blood Cultures and Imaging

Infective endocarditis should be considered with persistent bacteraemia, embolic phenomena, new regurgitation, prosthetic material or compatible systemic illness.

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Condition2 min read

Inflammatory Bowel Disease in Pregnancy

Active IBD at conception or during pregnancy increases adverse outcome risk. Maintaining remission is usually safer than stopping effective therapy.

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Clinical Reference2 min read

Inherited Thrombophilia Testing

Reserve testing for situations in which the result will alter management or family counselling; avoid testing during acute thrombosis or interfering treatment.

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Clinical Management2 min read

Insulin Pump Therapy: Selection, Safety and Monitoring

Continuous subcutaneous insulin infusion can improve flexibility and glycaemic outcomes in selected people with type 1 diabetes.

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Condition2 min read

Interstitial Lung Disease: Initial Assessment and Multidisciplinary Diagnosis

Interstitial lung disease encompasses diverse inflammatory and fibrotic disorders. Diagnosis combines exposure history, autoimmune assessment, high-resolution CT, pulmonary physiology and multidisciplinary review.

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Clinical Intervention2 min read

Intravenous Fluid Resuscitation in Acutely Ill Adults

Fluid resuscitation aims to restore effective circulation when hypovolaemia or distributive shock is present. Give small, reassessed boluses rather than unmonitored large volumes.

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Clinical Measurement2 min read

Lactate Clearance and Serial Lactate Interpretation

Serial lactate measurements can help assess trajectory in shock and severe illness. Percentage change should be interpreted with timing, treatment, liver function and clinical perfusion.

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Condition2 min read

Large-Bowel Obstruction: Cancer, Volvulus and Emergency Care

Large-bowel obstruction is commonly due to colorectal cancer, diverticular stricture or volvulus.

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Clinical Management2 min read

Lipid Management in Cardiovascular Disease Prevention

Lipid management reduces atherosclerotic cardiovascular risk. Treatment intensity should reflect established cardiovascular disease, baseline risk, LDL response, tolerance and comorbidity.

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Laboratory Test3 min read

Liver Blood Tests: Pattern Recognition and Clinical Interpretation

A structured guide to hepatocellular and cholestatic patterns, synthetic function, bilirubin and escalation.

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Clinical Management2 min read

Liver Transplant Assessment and Referral

Liver transplantation is considered for decompensated cirrhosis, acute liver failure, selected cancers and metabolic disease.

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Clinical Management2 min read

Long-Term Oxygen Therapy: Assessment and Follow-Up

Long-term oxygen therapy improves survival in selected patients with chronic severe resting hypoxaemia. Assessment should occur when clinically stable.

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Condition2 min read

Lower Gastrointestinal Bleeding: Assessment and Investigation

Lower GI bleeding ranges from self-limited rectal bleeding to major haemorrhage. Initial assessment should determine haemodynamic effect, bleeding rate and likely source.

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Condition2 min read

Lung Cancer: Recognition, Referral and Initial Staging

Suspect lung cancer in patients with persistent respiratory symptoms, haemoptysis, weight loss, clubbing or suspicious imaging, particularly with relevant exposure history.

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Clinical Measurement2 min read

Lung Volumes: Restriction, Hyperinflation and Air Trapping

Static lung volumes distinguish true restriction from low FVC due to air trapping or poor effort and quantify hyperinflation.

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Clinical Reference2 min read

Major Haemorrhage: Haematological Management

Activate a major-haemorrhage protocol, control the source, prevent hypothermia and acidosis, and use laboratory or viscoelastic guidance for component therapy.

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Condition2 min read

MASLD: Assessment, Fibrosis Risk and Management

MASLD is hepatic steatosis associated with metabolic risk and can progress to steatohepatitis, fibrosis and cirrhosis.

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Clinical Reference2 min read

Massive Transfusion Complications

Monitor ionised calcium, temperature, potassium, acid-base status, fibrinogen and dilutional coagulopathy during high-volume transfusion.

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Clinical Measurement8 min read

Mean Arterial Pressure: Measurement, Targets and Clinical Interpretation

A detailed guide to MAP calculation, measurement reliability, organ perfusion, shock targets and patient-specific interpretation.

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Condition3 min read

Metabolic Acidosis: Classification, Investigation and Clinical Management

A comprehensive guide to high-gap and normal-gap metabolic acidosis, compensation, mixed disorders and emergency causes.

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Condition3 min read

Metabolic Alkalosis: Causes, Chloride Responsiveness and Management

A guide to metabolic alkalosis, vomiting, diuretics, mineralocorticoid excess, urine chloride and safe management.

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Clinical Reference2 min read

Microcytic Anaemia

Differentiate iron deficiency, thalassaemia, inflammation, sideroblastic disease and lead toxicity using ferritin, transferrin saturation, CRP and haemoglobin studies.

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Condition2 min read

Mitral Regurgitation: Primary and Secondary Disease

Mitral regurgitation may be primary valve disease or secondary to ventricular or atrial remodelling. Assessment requires mechanism, severity, chamber response, pulmonary pressure and symptoms.

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Condition2 min read

Mitral Stenosis: Severity, Rhythm and Intervention

Mitral stenosis is commonly rheumatic and causes left atrial hypertension, pulmonary hypertension and atrial fibrillation. Valve area, mean gradient, heart rate and flow all influence severity assessment.

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Clinical Reference2 min read

Myelodysplastic Syndromes

Classify cytopenic clonal marrow disease using morphology, cytogenetics and molecular data and estimate risk to guide supportive or disease-modifying treatment.

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Condition2 min read

Myocarditis: Clinical Recognition and Diagnostic Strategy

Myocarditis ranges from mild chest pain to fulminant heart failure, arrhythmia or shock. Diagnosis integrates biomarkers, ECG, echocardiography, cardiac MRI and selected biopsy.

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Condition2 min read

Myxoedema Coma: Recognition and Emergency Management

Myxoedema coma is severe decompensated hypothyroidism with altered consciousness, hypothermia and organ dysfunction.

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Condition2 min read

Necrotising Pancreatitis: Infection, Intervention and Step-Up Care

Pancreatic or peripancreatic necrosis may remain sterile or become infected. Clinical deterioration after the first week raises concern for infection.

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Clinical Score2 min read

NEWS2: Interpretation, Escalation and Limitations

NEWS2 standardises assessment of acute physiological deterioration using respiratory rate, oxygen saturation, supplemental oxygen, temperature, systolic pressure, pulse and consciousness.

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Clinical Measurement2 min read

Non-Invasive Liver Fibrosis Assessment

Non-invasive fibrosis assessment combines simple serum scores, proprietary biomarkers and elastography.

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Clinical Intervention2 min read

Non-Invasive Ventilation in Acute Respiratory Failure

Non-invasive ventilation provides positive-pressure ventilatory support without an invasive airway. Established indications include selected acute hypercapnic respiratory failure and acute cardiogenic pulmonary oedema.

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