…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…

…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…

…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…

…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…

…appendage . Such thrombi may leave the appendage and enter the systemic circulation which causes thromboembolic occlusions of arteries in the brain, limbs or other organs…

…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…

…mucosal lesions, or hypersensitivity. Interactions Pharmacodynamic interactions Anticoagulants, thrombolytics, or other platelet aggregation inhibitors: Salicylates inhibit platelet function and enhance the effect of anticoagulants, increasing…

…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…

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

…plasmapheresis or other extracorporeal therapy (requires a large bore dialysis catheter, not an ordinary triple lumen catheter). Measurement of central venous pressure and central venous…

…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…

…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…

…not the skin. Aspiration needle (iliac crest or sternal needle with stylet) and a Jamshidi type biopsy needle. Syringes: a small 5–10 mL syringe…

…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…

…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…

…often necessary to normalize blood pressure. Management of hypertension requires careful consideration of other cardiovascular risk factors and coexisting conditions. Therapy must be tailored to…

…or beside them. Anticoagulant treatment is not a contraindication to these superficial injections. Preparation and equipment Chlorhexidine in alcohol, an iodine solution or isopropyl alcohol…

…chlorhexidine in alcohol, sterile gloves, a face mask. An atraumatic needle (pencil point, Sprotte or Whitacre), 22–25 G. A cutting needle (Quincke) only when…

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

…cautiously [1,3]. Euglycaemic DKA Euglycaemic DKA means ketosis and metabolic acidosis despite a normal or only moderately raised glucose, often below 13.9 mmol…

…lighter fluid Others Cyanide, boric acid, fluoride Preparation and equipment Medicinal charcoal as a ready made suspension or as a powder for suspension in water…

…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…

…Excessive alcohol consumption Diets high in carbohydrate or fat Glucocorticoids Beta blockers Oestrogen therapy Some antiretroviral therapies Post transplant medications, including corticosteroids, cyclosporine and sirolimus…

…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…

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

…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…

…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…

…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…

…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…

Procedurer A monoarthritis is septic until proven otherwise, and the only thing that proves otherwise is the synovial fluid. The aspiration is technically simple — what…

…vessel is difficult to puncture. Sterile preparation with chlorhexidine in alcohol 5 mg/mL, sterile drape, sterile gloves, mask and cap. Lidocaine 10 mg/mL…

…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).

…mL and 50 mL syringes. Therapeutic drainage: a commercial paracentesis set or a catheter over needle, 16–18 G, connected to tubing and a collection…

…tap water or sodium chloride 9 mg/mL. The volume matters more than the fluid; irrigate under pressure through a 20 mL syringe and a…

…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…