Snake venom detection kits (VDKs) are no longer recommended. The NSW Health
Snake and Spider Bites Clinical Management guideline (GL2024_007, June 2024, 4th
edition) reverses the prior advice not to wash a snake bite wound so it could be
swabbed for VDK testing — VDKs carry a high false-positive rate, mostly from operator
error. Point-of-care INR/D-dimer testing is also no longer used (false negatives
occur in severe VICC) — only formal laboratory results are trusted. See
Snake Bite.
Redback spider antivenom is no longer recommended as initial treatment, and is
now off the NSW Medicines Formulary entirely (individual-patient-use approval
required). Multimodal analgesia is now first-line; antivenom is only considered at a
senior clinician’s discretion if analgesia fails after 1–2 hours. See
Spider Bites.
Antivenom for snake bite is now given for clinical signs of envenomation before
blood results return, within a target window of 6 hours post-bite, rather than
waiting for laboratory confirmation. See Snake Bite.
Australia’s national Take Home Naloxone Program (free and prescription-free since
1 July 2022, including the intranasal Nyxoid spray) — offer it proactively to
patients on high-dose opioids or with a prior overdose. See
Opioid Overdose.
Sponge stings: fire sponges specifically can cause delayed erythema/desquamation
up to 2 weeks after contact. See
Penetrating Venomous Marine Injuries.
Poisons-information-centre thresholds: paediatric accidental paracetamol
ingestion <200mg/kg in an asymptomatic child needs only reassurance (not testing);
household chemical exposure and ocular decontamination (30-minute irrigation, target
pH 6.5–7.4). See Toxicology — General Approach and
Paracetamol Overdose.
Traveller’s diarrhoea now uses the ISTM functional severity classification
and specific loperamide dosing, per eTG’s December 2025 update, which also adds
C. difficile as a persistent-diarrhoea cause. See
Traveller’s Diarrhoea.
The pre-travel risk-assessment consultation was expanded (fitness-to-travel/
health-maintenance section, rabies bite-plan, environmental risks, ACTM resources),
sourced from the RACGP’s October 2025 AJGP travel medicine themed issue. See
The Travel Consultation.
New pages added
Pre-Travel Vaccinations — AJGP
Table 2/3 (commonly available vs. hard-to-source vaccines by transmission category),
plus a dedicated yellow fever/rabies section from the Australian Immunisation
Handbook (full 4-schedule rabies pre-exposure detail, ≥10-year yellow fever booster
criteria).
Burns — thermal, chemical and electrical
burns in general practice and urgent care: 20 minutes of cold running water
as first aid (effective up to three hours after injury), depth assessment by
capillary refill, rule-of-nines and palm-1% area estimation, the full ANZBA
burn-unit referral criteria, community dressing choice by depth, and the
time-to-healing thresholds (10/14/21 days) that drive later referral.
Drowning & Immersion — rescue safety,
responsive vs unresponsive assessment, CPR/AED/oxygen in drowning
(chest-compression-only strongly discouraged), hypothermic-patient
resuscitation modifications, disposition thresholds (4–8 hour ED
observation vs admission), delayed pulmonary oedema, and prevention.
Heat Illness & Heat Stroke — the
heat-illness spectrum from cramps/exhaustion through heat injury to
heat stroke, classic vs exertional heat stroke, assessment and
differentials, rapid cooling as the primary treatment (no drug reverses
it), and vulnerable-group/medication-review prevention advice for GPs.