…complex; (3) the P wave is positive in lead II and (4) the PR interval is constant. Causes of bradycardia : sinus bradycardia, sinoatrial block, sinoatrial…

…adult Abnormal relaxation (grade 1 dysfunction) Pseudonormal (grade 2 dysfunction) Reversible restrictive filling (grade 3 dysfunction) Irreversible restrictive filling (grade 4 dysfunction) E/A ratio…

…converting to Torsade de Pointes ventricular tachycardia. Notice how arterial blood pressure (ABP) drops at the onset of TdP. ECG by Nakstad et al (Scand…

…combination with acetylsalicylic acid (ASA), is indicated for the prevention of atherothrombotic events in adult patients with acute coronary syndromes (ACS), including: Unstable angina (UA…

…applies where you work. They assume normal renal and hepatic function, a non pregnant adult of normal weight, and individual assessment. See the separate quick…

…it further. Starting doses in acute pain in an opioid naive adult Agent Route Starting dose Comment : : : : Morphine IV 2.5–5 mg, repeated after…

…in the same systematic way as in adults, but against the age specific reference values below. Method of interpretation Heart rate Heart rhythm The P…

…the prevention of atherothrombotic events in adult patients with acute coronary syndrome (ACS) or a prior heart attack and a high risk of developing an…

…time due to the advent of more efficacious agents with wider therapeutic to toxic windows, and its routine use in adult patients is generally discouraged…

…those used for non pregnant adults. The fetus is not harmed by defibrillation, amiodarone, or adrenaline (epinephrine). In the event of a cardiac arrest in…

…as part of balanced transfusion in massive haemorrhage. Transfusion thresholds in the stable, non bleeding patient Patient category Transfusion threshold (Hb) : : Most stable adult inpatients…

…a fuller account of two of the commonest acute drug problems, see Warfarin therapy and Opioid therapy in severe pain. Cardiac arrest Drug Adult Child …

…the general adult population, but this figure rises steeply with age, exceeding 10% in individuals over 70 years [48] . The lifetime risk of developing HF…

…in ECG interpretation in adults. The ECG must always be interpreted using a systematic approach in order to minimize the probability of missing significant abnormalities…

…have been discussed in the chapter The ECG Leads. Acquisition of ECGs in pediatric patients is slightly different from adults, due to obvious anatomical differences…

Echocardiography Principles of echocardiographic examinations In small children, it is possible to perform the entire transthoracic echocardiography (TTE) with the child in the supine position…

…irrespective of sex Mid upper arm circumference Midpoint of the upper arm < 23 cm suggests undernutrition in adults Calf circumference Largest circumference < 31…

…and a warm, well perfused hand carry more weight. Choice of vessel The radial artery is the first choice : superficial, easy to compress, with a…

Procedurer What determines the outcome of an emergency intubation is rarely the laryngoscopy itself but what was done before it: how well the patient was…

…in which the patient reaches hospital early. The benefit of both methods falls steeply with the time since ingestion, and both can harm the patient…

…L) — choose the subcutaneous route if possible, otherwise give IM with a fine needle and 5 minutes of compression. Anticoagulant treatment is not in itself…

…sizes in an adult: choose the larger , since a mask that is too small leaks and gives a poorer seal. Procedure Insertion of the laryngeal…

…pressure. A value of around 0.9 to 1.0 or higher in an adult trauma patient suggests significant hypovolaemia and an increased transfusion requirement…

…the early warning sign. Choice of agent Situation Choice Reason : : : An opioid naive adult with normal renal function Morphine The reference drug, with the greatest…

…of sodium bicarbonate 1–2 mmol/kg intravenously in symptomatic salicylate poisoning. For an adult this corresponds to the order of 100–200 mL of…

…Myocardial bridging is an anatomical variant in which a segment of an epicardial coronary artery passes through the myocardium rather than remaining on the epicardial…

…moderate or near a treatment decision threshold. Failure to account for a high Lp(a) level may lead to substantial underestimation of cardiovascular risk. Conversely…

…in adult patients with severe pulmonary stenosis, alongside right ventricular hypertrophy (RVH) and right atrial enlargement [8]. RAD is present in most cases of significant…

…3 mg/kg Body weight 50 kg: Adult dosage. Adverse effects Adverse effects typically persist <10 seconds due to the short half life of adenosine…

…adult with T wave inversions in V1–V4, or other ECG changes (see below) should lead to a suspicion of ARVC. The gradual loss of…

…and practice of resuscitation medicine. Kitamura T, Kiyohara K, Sakai T, et al. Epidemiology and outcome of adult out of hospital cardiac arrest of non…

…cohort study of adult in hospital cardiac arrest. Resuscitation 2016; 98:10511. Saarinen S, Nurmi J, Toivio T, et al. Does appropriate treatment of the…

…cohort study of adult in hospital cardiac arrest. Resuscitation 2016; 98:10511. Saarinen S, Nurmi J, Toivio T, et al. Does appropriate treatment of the…

…cohort study of adult in hospital cardiac arrest. Resuscitation 2016;98:10511. Saarinen S, Nurmi J, Toivio T, et al. Does appropriate treatment of the…

…and practice of resuscitation medicine. Kitamura T, Kiyohara K, Sakai T, et al. Epidemiology and outcome of adult out of hospital cardiac arrest of non…

…Adults with congenital heart disease are mostly managed in GUCH clinics (Grown Up Congenital Heart disease). Prevalence of congenital heart disease (CHD) Congenital heart disease…

…worldwide have hypertension. Symptoms of hypertension Hypertension is most often asymptomatic. The high prevalence and asymptomatic nature of the disease motivates liberal screening among adult

…decreases and vice versa. The physiological purpose of this phenomenon is to allow for faster cardiac cycles during tachycardia (e.g during physical exertion). Therefore…

…oedema and mucus plugging. Expiratory flow limitation causes air trapping and dynamic hyperinflation. The consequences are increased work of breathing, exhaustion and, in the most…

Akutsjukvård Psykiatri Lathundar Delirium in older adults: quick reference A quick reference for ward and on call physicians: recognise hypoactive delirium, stabilise the patient, work…

…in the same order every time, reduces the risk of missing abnormalities. The eight steps below go through the rhythm and then the waveforms one…

…Older adults have a higher absolute cardiovascular risk than younger adults. Thus, although a smaller number of older patients may need treatment to prevent one…

Referensvärden The normal values below apply to adults in sinus rhythm, recorded at a paper speed of 50 mm/s with 1 mV = 10…

Info [calc_vernakalant] Indications for vernakalant Vernakalant (Brinavess) is indicated in adults for chemical conversion of recent onset atrial fibrillation to sinus rhythm. Vernakalant is…

…toxicity In adolescents and young adults, intoxication events leading to cardiac arrest are notably prevalent, primarily due to the misuse of prescription medications and illicit…

Neurologi Akutsjukvård Lathundar Definition and aims of treatment Convulsive status epilepticus in adults is present with: an ongoing generalised tonic clonic seizure lasting at least…

…pulmonic) regurgitation Pulmonary regurgitation is also called pulmonic regurgitation . The majority of all adults exhibit a small pulmonary regurgitation, which is considered a normal finding…

Infektionssjukdomar Akutsjukvård Lathundar Purpose and scope A quick reference for the doctor on call faced with suspected sepsis in adults: rapid recognition, microbiological sampling, empirical…

…chronic coronary disease, cerebrovascular disease, and peripheral arterial disease. More than 70% of older adults presenting with myocardial infarction, stroke, acute aortic syndromes, or heart…

…during infancy & childhood In adults, the left ventricle is considerably larger than the right ventricle. This is the result of ventricular adaptation to the resistance…

…during infancy & childhood In adults, the left ventricle is considerably larger than the right ventricle. This is the result of ventricular adaptation to the resistance…

Referensvärden Reference ranges are statistical: by definition they encompass 95 % of a healthy reference population, which means that one healthy value in twenty falls outside…

…electrolyte concentrations and level of care. This quick reference is intended primarily for adults and summarises the order in which measures are taken and the…

…Fewer than half of patients with PAD have typical symptoms. Many have impaired walking or a slow gait without describing classic claudication. In older adults…

…T wave Assessment of the T wave represents a difficult but fundamental part of ECG interpretation. The normal T wave in adults is positive in…

…young adults has increased in recent years ( Nabel et al, Savarese et al ). This is a paradoxical and worrisome trend, particularly in light of the…

…young adults has increased in recent years ( Nabel et al, Savarese et al ). This is a paradoxical and worrisome trend, particularly in light of the…

…Children and healthy adults may also develop tachycardia induced cardiomyopathy (Gopinnathair et al). Long term prognosis is excellent, with the vast majority of patients recovering…

…for dialysis? AKI occurs in about one fifth of adults during a hospital episode in international studies and is linked to substantial mortality, even though…

…Choice of site The posterior superior iliac spine is the standard site for both aspiration and biopsy in adults. Here the posterior part of the…