…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…

…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…

…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…

…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…

…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 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…

…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…

…potassium, cytotoxic drugs, parenteral nutrition. The need for several simultaneous, incompatible infusions. Haemodialysis, plasmapheresis or other extracorporeal therapy (requires a large bore dialysis catheter, not…

…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…

…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…

…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…

…and the current treatment target levels for patients with and without diabetes. The threshold for hypertension is currently 140 mm Hg systolic or 90 mm…

…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…

…pressure with bradycardia. A known or suspected intracranial space occupying lesion with mass effect and midline shift. Ongoing anticoagulant treatment or marked coagulopathy. A platelet…

…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…

…The condition occurs above all in: treatment with SGLT2 inhibitors pregnancy prolonged fasting or a very low carbohydrate intake excessive alcohol consumption vomiting or othe

…ineffective and management is instead governed by the antidote, supportive treatment or dialysis: Group Examples : : Metals and salts Iron, lithium, potassium, lead, mercury Alcohols and…

…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…

…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…

…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…

…with manifest clinical disease are at high risk of progression and generally require all appropriate evidence based measures, including drug treatment and therapeutic lifestyle change…

…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…

…complication rate. The femoral artery is the second choice and is often the best in marked shock or during high dose vasopressor treatment, when the…

…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).

…recurrent treatment. Contraindications There are in practice no absolute contraindications; suspected spontaneous bacterial peritonitis carries more weight than a deranged coagulation profile . Avoid or modify…

…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…

…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…