…65, and concomitant drug/alcohol use. Some studies suggest HAS BLED has comparable or slightly superior predictive capability for major bleeding compared to ATRIA. ORBIT…

…time, and whether the intake was single or repeated a modified release preparation or a combination product concurrent drugs, alcohol and illicit substances weight, age…

…renal or liver function, prior stroke, bleeding tendency or previous bleeding, labile international normalized ratio (INR), older age, drugs predisposing to bleeding and alcohol use…

…a meal or with continued glucose administration adapted to the cause. 8. Identify drugs, renal failure, alcohol, a missed meal, physical activity and any other…

…Labile INRs, Elderly age ( 65), and Drugs/alcohol. A crucial clinical pitfall is the misapplication of this score. A high HAS BLED score (≥3) indicates…

…begin before the blood alcohol concentration has reached zero, and several syndromes can overlap [1,4]. Time after a clear reduction or the last intake…

…bradyarrhythmic cardiac arrest or asystole may result from reversible systemic insults, including hypovolemia, hypoxia, cardiac tamponade, tension pneumothorax, preexisting acidosis, drug overdose, hypothermia, and hyperkalemia…

…Preparation and equipment Ultrasound with a curved array or linear probe. Sterile clothing: gown, gloves, cap, mask, fenestrated drape. Chlorhexidine in alcohol 5 mg/mL…

…a change in medication or an exposure Concussion, temporal bone injury, dissection, aminoglycoside toxicity, antiepileptic drugs, alcohol or sedatives Trauma and medication directed workup This…

…fails or is judged futile. Children in an emergency, where peripheral venous access often takes too long. Intraosseous access accepts all drugs, fluids and blood…

…antidepressants reduces the effect of clonidine. • Clonidine increases the CNS depressive effects of alcohol and sedatives. Clonidine doses and administration in hypertension (hypertensive crisis/emergency).

…intensity and duration of exposure to cardiovascular risk factors. Primary prevention Primary prevention targets people without clinical CVD who nevertheless have established risk factors or…

…pregnancy or malignancy. A markedly raised GGT with the other tests normal is most often enzyme induction by alcohol or drugs and is often of…

…example foreign body, hanging or strangulation. Drug overdose Intentional or accidental overdose of medications, drugs or other substances (including alcohol) causing cardiac arrest. Table 1…

…a dialysis fistula. Preparation and equipment Hand disinfection; gloves where there is a risk of blood contact. An alcohol or chlorhexidine swab. Let the skin…

…substances (alcohol, amphetamine, coffee, anticholinergic drugs, beta adrenergic agonists). In all of these conditions, sinus tachycardia is merely an expression of an underlying disease or…

…Besides anticoagulation, atrial fibrillation is treated with rate and/or rhythm control . Rate control implies the use of medications that slow ventricular rate (beta blockers…

…ingested substance has the propensity to form bezoars or is a sustained release formulation. Note: activated charcoal is ineffective against alcohols, lithium, and heavy metals…

…daily. Warnings and precautions Use Aspirin with caution in the following cases: Concurrent anticoagulant therapy (e.g., coumarin derivatives or heparin—except low dose heparin)…

…a high frequency linear probe, a sterile probe cover and sterile gel. Chlorhexidine in alcohol 5 mg/mL for skin disinfection. Allow it to air…

…drinks for women or five for men on one occasion. Pharmacokinetics and pathophysiology Approximately 95% of ingested ethanol undergoes hepatic metabolism. Alcohol dehydrogenase converts ethanol…

…sufficient for the assessment of pH and bicarbonate. An arterial blood gas is needed mainly when concomitant respiratory failure or an exact assessment of oxygenation…

…Recognised causes include: Diabetes and insulin resistance Thyroid disease Kidney disease Excessive alcohol consumption Diets high in carbohydrate or fat Glucocorticoids Beta blockers Oestrogen therapy…

…myelodysplastic syndrome or myeloproliferative neoplasm. Work up and staging of lymphoma and myeloma. Suspected bone marrow metastasis. Assessment of treatment response and measurement of residual…

…Preparation and equipment Chlorhexidine in alcohol or an iodine solution. Lidocaine 10 mg/mL without adrenaline for the block (adrenaline is safe in fingers and…

…Preparation and equipment Chlorhexidine in alcohol or an iodine solution. Lidocaine 10 mg/mL with adrenaline 5 µg/mL (adrenaline gives a bloodless field and…

…pulmonary embolism, pneumothorax). Hypertension. Smoking. Dyslipidemia (hyperlipidemia). Obesity and/or diabetes. Psychosocial stress. Alcohol abuse. Physical inactivity. Unhealthy diet. Cerebral / peripheral vascular disease. Cancer. Acute…

…indication and an emergency procedure . An unclear arthritis, as part of the diagnostic work up. Haemarthrosis after trauma. A symptomatic effusion causing pain or restricted…

…blood loss or large volume shifts. Patients in whom non invasive measurement is unreliable: marked obesity, pronounced vasoconstriction, arrhythmia, intra aortic balloon pump. Assessment of…

…used. Studies have shown that it performs similarly or superiorly to other bleeding risk assessment tools, such as HEMORR2HAGES, ATRIA, ORBIT, and GARFIELD AF scores…

…currently 140 mm Hg systolic or 90 mm Hg diastolic (140/90 mm Hg). The discordance between optimal blood pressure and the definition of hypertension…

…the opening pressure in suspected idiopathic intracranial hypertension. Therapeutic drainage in idiopathic intracranial hypertension and in assessment before shunt surgery. Contraindications Clinical signs of herniation —…

…Preparation and equipment Chlorhexidine in alcohol, an iodine solution or isopropyl alcohol. A depot glucocorticoid: triamcinolone hexacetonide (Lederspan 20 mg/mL) or methylprednisolone acetate (Depo…

…over the insertion site Change the puncture site Preparation and equipment Ultrasound with a curved array probe. Sterile preparation (chlorhexidine in alcohol 5 mg/mL)…

…without being found. Indications A traumatic wound that gapes and cannot be expected to heal with good function or cosmesis without apposition. A wound that…

…absolute indication, and always urgent. A large pericardial effusion with symptoms despite medical treatment. Diagnostic drainage in suspected purulent pericarditis, tuberculosis or malignancy. Tamponade is…

…endoscopic assessment more difficult and causes vomiting Medicinal charcoal Petroleum products — vomiting with chemical pneumonitis as a consequence Medicinal charcoal Bowel obstruction, ileus or suspected…