CIAP Newsletter

CIAP provides a wide range of resources to support NSW Health staff caring for patients with disorders of the nerves and nervous system, including epilepsy, stroke, dementia, Alzheimer's disease, neuromuscular disorders, multiple sclerosis, vestibular disorders, neurological pain, neurodegenerative diseases and more.

The Neurology Specialty Guide, located by selecting 'Specialty Guides & Links' from CIAP's left menu is a good place to browse the resources that are currently available. The guide contains recommended CIAP resources, a selection of online journals and books along with NSW Health and other recommended guidelines and websites, including Epilepsy Australia which promotes epilepsy awareness month in March each year. The Rehabilitation Specialty Guide may also be of interest, particularly for occupational therapists, nurses, psychologists and other staff working in rehabilitation settings in hospitals and the community.

A useful resource providing a dedicated topic area for neurology is the Cochrane Library. Found through 'Evidence-Based Practice' in CIAP's left menu, Cochrane provides a comprehensive database of systematic reviews. On the Cochrane homepage, scroll down the page to find the Browse by Topic section. Select 'Neurology' to find systematic reviews and/or protocols in 24 sub-categories including stroke (220 documents in 9 categories), multiple sclerosis (61 documents), Motor neurone disorders (27 documents) and fibromyalgia (30 documents).

The Cochrane Library also provides access to the Cochrane Journal Club, where you can access podcasts, downloadable PowerPoint slides, discussion points and clinical scenario presentations on a range of systematic review topics for discussion in the clinical setting. Of particular interest may be #54 Treatment for epilepsy in pregnancy: neurodevelopmental outcomes in the child, #52 Thrombolysis for acute ischaemic stroke and #39 Selective serotonin reuptake inhibitors (SSRIs) for stroke recovery. You can find the Journal Club by selecting 'More Resources' on Cochrane's homepage.

Other CIAP resources that provide topic areas for neurology include BMJ Clinical Evidence and the Therapeutic Guidelines (eTG). Simply select the neurology topic on the selected resource homepage to view the information available.

CIAP's left menu provides access to a number of eBooks via 'Books & Dictionaries' including:

The AccessMedicine platform for viewing eBooks also provides links to multimedia, slides, algorithms, flow charts, videos of neurological examination techniques, case studies and images. These can be accessed from the top menu options. Allied health topics can also be searched, as well as a wide variety of patient education leaflets.

The New England Journal of Medicine (NEJM) provides access not only to the latest edition of the journal itself, but also to a range of multimedia options. From the NEJM homepage, use the top menu to select and view the 'Neurology/Neurosurgery' specialty area. This will allow you to view articles from multiple NEJM issues about this topic, along with podcasts, videos, key research and information about related conferences and more. You can also subscribe to receive updates on specialty topics by selecting the 'Sign Up' link located on the right of the specialty page.

To learn more about specific diseases and conditions, you can utilise the search features in BMJ Best Practice, Harrison’s Principles of Internal Medicine, PEMsoft and eTG, to locate information about a disorder. Try searching 'epilepsy' to see the range of evidence-based information that each resource provides. BMJ Best Practice, for example, provides condition monographs for various types of seizures in adults and children, a patient information leaflet, links to systematic reviews, assessment guidelines (including emergency and urgent considerations) and treatment protocols.

To learn more about the resources available through CIAP, visit the Learning Centre for a range of workshops, user guides, elearning modules and video tutorials.

CPD

CIAP Update

New CIAP Specialty Workshops open for registrations

Registrations are open for CIAP's new specialty workshops Emergency & Critical Care and Paediatrics.

The CIAP Emergency & Critical Care Workshop will be held on 21 April at Royal Prince Alfred Hospital and will focus on access and navigation of CIAP resources in the emergency, critical care and ambulance contexts. Staff located statewide from Emergency, Ambulance, ICU, NICU, Perioperative, High Dependency and Organ Transplant departments are welcomed to attend.

The CIAP Paediatrics Workshop will be held on 11 May at the Children's Hospital at Westmead and will focus on accessing CIAP resources and evidence relevant to paediatric practice. NSW Health staff working across all NSW locations are welcomed to attend.

The programs for these and other specialty workshops are available from CIAP's Knowledge Centre, accessible from the top menu bar. Registration is through HETI Online, where your attendance will be logged in your learning history.

Other specialty workshops being held in 2016 include Allied Health, Evidence-Based Practice, Mental Health, CIAP Train the Trainer and Community Health.

If you would like to register for a CIAP workshop, but don’t have a HETI Online login, please contact the CIAP Educator.

Epilepsia

Article in Focus

A definition and classification of status epilepticus – Report of the ILAE Task Force on Classification of Status Epilepticus

Epilepsia 56(10): October 2016, p 1515-1523

The International League Against Epilepsy (ILAE) charged a Task Force to revise concepts, definition, and classification of status epilepticus (SE). The report concluded:

The revised definition is conceptual, with two operational dimensions, t1 and t2:

  1. the first is the length of the seizure and the time point (t1) beyond which the seizure should be regarded as “continuous seizure activity.”
  2. the second time point (t2) is the time of ongoing seizure activity after which there is a risk of long-term consequences.

Generalized convulsive SE in adults and children older than 5 years was operationally defined as “. . .≥5 min of (1) continuous seizure or (2) two or more discrete seizures between which there is incomplete recovery of consciousness”.

ETG complete logo

Gems on CIAP

Drugs used for Parkinson's disease and ‘Parkinson plus’ disorders

The Therapeutic Guidelines (eTG) provide clear, practical and comprehensive therapeutic information and guidelines for a range of diseases, disorders and their treatments. Drawing on the latest international literature, interpreted by some of Australia’s most eminent and respected experts, eTG focusses on promoting the quality use of medicines in the Australian context.

One of the many tables provided by eTG summarises the various drugs that may be used in the treatment of Parkinson's disease, and is useful as a quick reference and comparative guide. This table can be accessed by selecting Therapeutic Guidelines and then 'Neurology' from the list in the centre panel of the opening page. From there, select ‘List of tables, boxes and figures’ (second last option), and open Table 7.9: Drugs used for Parkinson's disease and ‘Parkinson plus’ disorders.

Table 7.9 lists information about the class and name of drugs, the usual dose range along with comments about dosing, and adverse effects. Note the orange ‘i’ buttons on the right-hand edge of drugs listed in the table. A drop down menu on each button details the class of that drug for pregnancy and breastfeeding, as well as PBS information where relevant.

eTG can be accessed from the ‘Medications’ tab on the left menu of the CIAP home page.

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