…different insulin sensitivity from at home: less food, more stress, often corticosteroids, often impaired renal function. Prescribe basal insulin, mealtime insulin and the correction dose…

…of standing in older patients, patients with diabetes and anyone with dizziness Definitions White coat hypertension: a raised office reading but normal readings at home…

…8. Document the diagnosis and communicate it at every handover. Recognise it Core criteria Core criterion Meaning : : Acute onset The change has developed over hours…

…infection or gastroenteritis at home Double or triple the oral daily dose during the days of illness (the patient's sick day rules) Vomiting or…

…home or ambulatory pressure. Office measurements provide only a limited representation of usual blood pressure and may be biased by the clinical environment. Out of…

…many other causes of acute dyspnoea: oxygen must be titrated cautiously and the blood gas determines the need for ventilatory support . At the same time…

…for at least 4–8 hours after anaphylaxis that required treatment; biphasic reactions occur. Everyone must go home with an adrenaline auto injector and written…

…with all agents prescribed at maximum or maximally tolerated doses. The apparently uncontrolled office blood pressure must be confirmed using home blood pressure monitoring or…

…be increased at an appropriate intensity, with attention to the emergence of symptoms. Evaluation Before Rehabilitation Clinical assessment Rehabilitation begins with patient assessment and ongoing…

…and backwards along the superior wall of the ear canal , past the plug — not straight at it. The water should get behind the wax and…

…who experienced chest pain at home may be asymptomatic during the assessment in the ER, only to develop severe chest pain and magnificent ST elevations…

…old hole. Infection or burns over the puncture site. Osteogenesis imperfecta and severe osteoporosis (relative). An inability to identify the landmarks. Choice of vein and…

…and epinephrine) and defibrillation procedures should be deferred until the body temperature exceeds 30°C. This is due to the diminished efficacy of these interventions at…

…factors include pulmonary disorders, particularly obstructive pulmonary disease, the use of theophylline, and elevated catecholamine states. EAT typically has an abrupt onset, although a brief…

…In the setting of acute coronary syndrome (ACS), DAPT is used to reduce recurrent myocardial infarction, stent thrombosis and other ischemic events after coronary angiography…

…of age, where iso BMI or percentile charts should be used. Waist circumference Measure the waist between the lowest rib and the iliac crest, at…

…speed of 50 mm/s with 1 mV = 10 mm. At 50 mm/s a small square (1 mm) corresponds to 20 ms and…

…of the nose. 7. When the tip reaches the pharynx: let the patient take a mouthful of water and hold it. Advance the electrode at…

…Akutsjukvård Lathundar Definition and aims of treatment Convulsive status epilepticus in adults is present with: an ongoing generalised tonic clonic seizure lasting at least 5…

…uncomplicated acute coronary syndrome when LVEF is 40% is not definitive. Observational studies have yielded conflicting results, and the appropriate duration of therapy in p

…strategy involving coronary angiography and subsequent revascularization may be undertaken early, delayed, or selectively after initial medical treatment. The presence of ST segment changes or…

…deliver blood at a rate appropriate to tissue requirements unless filling pressures are elevated. The syndrome is therefore defined by symptoms and signs of congestion…

…troponin with at least one value above the 99th percentile upper reference limit; and Clinical evidence of acute myocardial ischaemia. At least one of the…

…small vessels, multivessel disease, bifurcation lesions, treatment of acute myocardial infarction Procedural and mechanical Stent underexpansion, incomplete wall apposition, residual inflow or outflow disease, edge…

…with UA has declined. Clinical Presentation and Symptoms The clinical spectrum of ACS is broad. Patients may be asymptomatic at presentation, have persistent chest discomfort…

…Definition and staging according to KDIGO Acute kidney injury is present when at least one of the following criteria is met [1]: A rise in…

…work of breathing, level of consciousness and PEF improve at the same time. Acute severe asthma is characterised by bronchospasm, mucosal oedema and mucus plugging…

…An ABI ≤ 0.90 is diagnostic of peripheral arterial disease and at the same time indicates a substantially increased risk of myocardial infarction and stroke…

…Drug Standard dose Reduced dose and criterion : : : Apixaban 5 mg twice daily 2.5 mg twice daily if at least two of: age ≥80 years…

…anaesthetic also improves the chance of success by counteracting vascular spasm. Pressure monitoring set: stiff, short tubing, a transducer, and a flush system with physiological…

…why mixed acid base disorders are missed. The blood gas describes the physiology at the moment of sampling, but does not by itself identify the…

…wrong patient — a mislabelled tube, or an identity check performed at the nurses' station instead of at the bedside. The check against the patient's…

…0 mmol/L Triglycerides < 1.7 mmol/L 10 carries a risk of pancreatitis Cardiac markers and coagulation Test Reference Comment : : : High sensitivity troponin…

…Q waves (≥ 0.03 s and/or an amplitude ≥ 25 % of the R wave amplitude in the same lead, in at least two contiguous leads)…

…the test in the event of bradycardia, bronchospasm, marked salivation or increasing weakness, and give atropine. 8. Monitor for at least 30 minutes after the…

…of chronotropic function and pacemaker settings. Preoperative functional assessment before major surgery. At a low pre test probability most positive results are false positives; at…

Procedurer For many patients a gynaecological examination is associated with a sense of exposure, and technically correct performance is only half the task. The examination…

…A patient with a plasma potassium of 6.2 mmol/L, new bradycardia and acute kidney injury may be at greater immediate risk than a…

…limit the damage. The choice of drug, the target pressure and the rate of treatment are determined by the affected organ function, not by the…

…about 7.20. Different targets apply when the intracranial pressure is raised: normocapnia (PaCO₂ 4.5–5.0 kPa) and avoidance of hypoxia, since hypercapnia…

…is felt — the tip of the cuff then lies at the oesophageal inlet. 6. Inflate the cuff to a seal, connect the capnograph and v

…height and ethnicity — not against absolute figures. Since 2022 the z score with a lower limit of normal at z = −1.64 (the fifth…

…at the same time [1]. Activate the local major haemorrhage protocol early. Protocols improve above all the logistics, the communication and the simultaneous delivery of…

…release tablet and an as required opioid at the same time. Opioids in abdominal pain of unclear cause do not delay the diagnosis and should…

…why, or the patient at risk of carbon dioxide retention is given 15 litres on a reservoir mask and drifts off into a respiratory acidosis…

…how wide the rim of fluid looks. With ultrasound guidance, the point at which the fluid lies most superficially is chosen and the needle is…

…The neurovascular status must be documented before and after every attempt at reduction — otherwise it is impossible to determine afterwards whether a nerve injury was…

…6. Take cortisol at 30 minutes and at 60 minutes . Some laboratories accept one of these time points — follow the local instructions, but where the…

…relief and rarely alters the natural history of the disease. In lateral epicondylitis the effect is in fact worse than no treatment at all at…

…is part of the treatment itself. Indications Salicylate poisoning with symptoms or a rising serum concentration. Alkalinisation increases renal elimination several fold and at the…

…of evidence A 12 lead ECG should be interpreted immediately (within 10 minutes) at first medical contact. I B ECG monitoring should start immediately and…

…Most AAAs are located below the renal arteries and are related to atherosclerotic disease. At least 90% of AAAs larger than 4 cm are associated…

…CTI) at the inferior boundary, and ascends in a caudocranial direction along the interatrial septum. The left atrium is activated passively. The upper boundary of…

…rate. Within the context of acute coronary syndromes, particularly ST elevation myocardial infarction (STEMI), ischemic injury can disrupt the conduction system at any level, producing…

…A history of increasing frequency of hospitalizations and visits for heart failure without disease recognition in the 3 years preceding diagnosis is also a notable…

…been estimated at approximately one in two for CVD, one in three for coronary heart disease, one in five for heart failure and one in…

…For asymptomatic stenosis of at least 70%, the reported 5 year ipsilateral stroke risk is 14.6%, and revascularisation may be beneficial in appropriately selected…

…do so only at the expense of abnormally high filling pressures. The resulting haemodynamic congestion produces a characteristic clinical phenotype of breathlessness, fatigue and oedema…

…require new ST elevation in at least two contiguous leads [8, 10]. The specific voltage thresholds vary based on patient age, sex, and lead location…

…with at least one value above the 99th percentile upper reference limit (URL). The injury is considered acute if there is a documented rise and…