…modified release preparation or a combination product concurrent drugs, alcohol and illicit substances weight, age, pregnancy and comorbidity renal and hepatic function regular medication and…

…heavy consumption is associated with hypertension, coronary artery disease, arrhythmias, heart failure and alcohol related cardiomyopathy. The cardiovascular implications of lower alcohol intake remain controversial…

…Heart failure, hypertension, diabetes and vascular disease. Age and sex category. Renal and hepatic function. Previous bleeding, bleeding predisposition, alcohol use and concomitant drugs that…

…vital functions artificially until the substance undergoes renal elimination, hepatic elimination or is removed by means of dialysis. Substance Antidot e Paracetamol (Acetaminophen) N Acetylcysteine…

…of the strongest risk markers for a new complicated withdrawal. Benzodiazepines enhance the function of the GABA A receptor and are cross tolerant with alcohol…

…history with early onset of heart failure is common among these individuals. The majority of the mutations are inherited in an autosomal dominant manner with…

…and the speed of the course. An AST/ALT ratio 2 with moderately raised values suggests alcohol related liver disease; a ratio < 1 suggests…

…recovered. 7. Follow up with a meal or with continued glucose administration adapted to the cause. 8. Identify drugs, renal failure, alcohol, a missed meal…

…blood contact. An alcohol or chlorhexidine swab. Let the skin dry completely before inserting the needle — alcohol carried in with the needle stings. Needles of…

…Preparation and equipment Chlorhexidine in alcohol 5 mg/mL: clean with 3–4 swabs in wide circles and let it dry for a couple of…

…with severe kidney disease (glomerular filtration rate < 30 mL/min). Patients with mild to moderate heart failure, kidney or liver disease, especially when combined…

…et al. Bleeding risk in ‘real world’ patients with atrial fibrillation: comparison of two established bleeding prediction schemes in a nationwide cohort. J Thromb Haemost…

…g in 1 ml vial. Dilute with 10 ml of normal saline and give by slow injection over 5 10 minutes. Dilute immediately before use…

…INR (International Normalized Ratio) E lderly (age 65 years) D rugs/alcohol concomitantly Each component is assigned 1 point, with a maximum score of 9…

…suppression is maintained. A change in antiretroviral therapy is not recommended in individuals with previous virological failure if it risks loss of suppression. Clinical presentation…

…sarcoidosis, rheumatic heart disease, connective tissue disease, eosinophilic myocarditis), toxins (alcohol, cocaine, cancer therapies), or physical reactions (radiation therapy), frequently involves the conduction system. In…

…risk factors or an elevated estimated risk. It combines lifestyle intervention with treatment of risk factors when indicated. Risk estimation is particularly important when deciding…

…atrial flutter, AVNRT and AVRT (pre excitation, WPW syndrome) being the most common. Atrial fibrillation with onset during hyperthyroidism (thyrotoxicosis), alcohol overdose, thoracic surgery, acute…

…regular with a positive P wave in lead II, but the heart rate exceeds 100 beats per minute. Although sinus tachycardia is the most common…

…Syndrome Typical course Common or important causes Targeted examination : : : : Acute vestibular syndrome Acute or subacute onset, continuous dizziness lasting hours to days, often with nausea…

…choice : superficial, easy to compress, with a dual collateral supply to the hand through the palmar arches and the lowest complication rate. The femoral artery…

…and coagulation screen, medication list. Chlorhexidine in alcohol, sterile gloves, fenestrated drape, sterile gauze. Local anaesthetic: lidocaine 10 mg/mL, usually 5–10 mL, with…

…probe cover and sterile gel. Chlorhexidine in alcohol 5 mg/mL for skin disinfection. Allow it to air dry completely before puncture. Maximal barrier precautions:…

…and the principles that are common to all protocols. Children, pregnant women and patients with advanced renal failure, marked heart failure or circulatory shock require…

…a patient with a reduced level of consciousness Gastric lavage Corrosive injury or suspected oesophageal perforation Gastric lavage Petroleum products Gastric lavage Oesophageal varices, coagulopathy…

…ulcer prophylaxis During mechanical ventilation, in coagulopathy, or with a history of gastrointestinal bleeding Refeeding syndrome There is a risk in starvation, alcoholism, anorexia nervosa…

…first. Preparation and equipment Informed consent, coagulation status and an up to date medication list. A sterile fenestrated drape, chlorhexidine in alcohol, sterile gloves, a…

…with the needle tip directed volarly until a weal forms over the volar nerve. Wait 10 minutes — insufficient waiting time is the commonest reason for…

…malignancy, tuberculous peritonitis or pancreatic ascites. Therapeutic paracentesis: Tense ascites with abdominal discomfort, early satiety or respiratory compromise. Diuretic refractory or diuretic intolerant ascites, as…

…effusion with symptoms despite medical treatment. Diagnostic drainage in suspected purulent pericarditis, tuberculosis or malignancy. Tamponade is a clinical diagnosis supported by echocardiography: Finding Comment…

…alcohol 5 mg/mL, gauze, a transparent dressing, an extension set with a three way tap, and saline for flushing. An intraosseous drill system with…

…new pleural effusion of unclear cause. An effusion not confidently explained by heart failure must be aspirated. Suspected empyema or complicated parapneumonic effusion. Suspected malignancy…

…without a definite diagnosis. Choice of technique Diagnostic question Method Comment : : : Pigmented lesion, suspected melanoma Excision with a 1–3 mm margin, down into the…

…See the separate guide to joint aspiration and injection. Indications Condition Injection site Comment : : : Subacromial bursitis, rotator cuff syndrome The subacromial space The best documented…

…with adrenaline 5 µg/mL Rapid 2–6 hours A bloodless field, less bleeding Mepivacaine 10 mg/mL Rapid Somewhat longer than lidocaine A common…

…is the most common sustained cardiac arrhythmia and a profound driver of global cardiovascular morbidity and mortality, primarily due to its association with ischemic stroke…

…and infarction Approach to patients with chest pain: differential diagnoses, evaluation and management Chest pain is one of the most common symptoms in the emergency…

…commonly stated that approximately 80% of all cardiac arrests are caused by acute or chronic coronary artery disease, with the latter being the most common…

…return to normal blood pressure (normotension). Combination therapy with multiple antihypertensives is often necessary to normalize blood pressure. Management of hypertension requires careful consideration of…