Clinical Snippets October 2025

Dr Dave teaches Dr Jo about Suicide prevention with new NHS and NICE guidance discouraging risk stratification tools and instead emphasising relational safety, a biopsychosocial approach, dynamic safety planning, inclusivity, and clear communication. Dr Dave covers paediatric gastroenteritis, a recent NEJM study confirms oral ondansetron’s effectiveness in reducing vomiting in children, with NZFC guidance supporting its use for dehydration-related cases. Privacy and safety intersect in the discussion of HIPC Rule 11, which allows clinicians to disclose health information without consent if there is a serious threat to life or health, provided specific criteria are met and documentation is thorough. In diabetes care, once-weekly insulin icodec is found to be as effective as daily long-acting insulins, though it is not yet approved in New Zealand and is more costly. Insomnia management advances include the approval of lemborexant, a DORA, with evidence supporting its efficacy and safety, though it remains unsubsidised. COPD management is updated with guidance on triple therapy and the role of eosinophil counts, while iron deficiency is clarified with new diagnostic and monitoring recommendations. Finally, Dr Jo learns about some adult ADHD management resources and gets recent insights into QTc-prolonging medications.