Clinical Knowledge Summaries (CKS): new topics and updates

 From NICE:

NICE Clinical Knowledge Summaries (CKS) topics are aimed at healthcare professionals working in primary and first contact care in the UK. The 370 topics cover 1000 clinical presentations or patient scenarios and are free to access.

The following CKS topics have been created or updated over the past months:

October:

• Angio-oedema and anaphylaxis – the topic has been updated to align with the Resuscitation Council UK guideline Emergency treatment of anaphylaxis. Guidelines for healthcare providers. Recommendations to routinely administer IV or IM chlorphenamine and hydrocortisone have been removed from this topic.
• Bunions – the section on Assessment has been moved to the diagnosis section to improve clarity and navigation and an additional section on surgical management has been added to the management section.
• Heart failure – chronic – advice to add iron studies as part of the assessment of a person with heart failure and to manage comorbidity of hypertension was added based on the European Society for Cardiology guidelines for the diagnosis and treatment of acute and chronic heart failure.
• Smoking cessation – history of epilepsy added to the cautions section for nicotine replacement therapy in line with updated manufacturer's SPC.

November:

• Anaemia – iron deficiency - the topic has been updated in line with the British Society of Gastroenterology guidelines for the management of iron deficiency anaemia in adults (2021).
• Candida – female genital - the treatment regimens for acute vulvovaginal candidiasis and for women with uncontrolled diabetes or other causes of immunocompromise have been updated, in line with the BASHH national guideline on vulvovaginal candidiasis (2019). The Scenarios on 'Severe infection' and 'Uncontrolled diabetes or immunocompromised' have been deleted, and their content incorporated into other Scenarios, for clarity and ease of navigation.
• Immunizations – seasonal influenza - a recommendation that children aged over 2 years with a history of severe anaphylaxis to egg who have previously required intensive care management in hospital can be offered the egg-free cell-based quadrivalent influenza vaccine (QIVc) as an alternative to referral to a specialist for immunization in hospital has been added to this topic.
• Non-alcoholic fatty liver disease (NAFLD) - content has been updated on prevalence, aetiology, complications, diagnosis, and management.
• Tiredness/fatigue in adults - updated to include the recommendations from the NICE guideline Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management [NG206] (2021). Changes include the range of blood tests which are recommended in assessing a person with suspected CFS, the timescale for referral, the range of supportive measures which should be considered and the follow up recommended in primary care.

December:

• Antenatal care – uncomplicated pregnancy - this topic has been updated in line with new NICE guidance on Antenatal care [NG201] which replaces the previous NICE guideline Antenatal care for uncomplicated pregnancies [CG62].
• Coronavirus – COVID-19 – the section on managing the long-term effects has been updated in line with the recently updated NICE guideline COVID-19 rapid guideline: managing the long-term effects of COVID-19.
• Female pattern hair loss (female androgenetic alopecia) – is the new title for Alopecia, androgenetic – female.
• Male pattern hair loss (male androgenetic alopecia) – is the new title for Alopecia, androgenetic – male.
• Otitis externa - Prescribing information section has been updated, and information on oral flucloxacillin and clarithromycin has been removed, as oral antibiotics are not routinely needed in primary care for the management of uncomplicated acute otitis externa, in line with current evidence in the literature.