…seizures and temperature management. The ICU is the preferred level of care for the absolute majority. The CCU may be suitable for stable (hemodynamically and…

…Acid–base and electrolytes in intensive care Neurological monitoring Parameter Target Comment : : : Intracranial pressure (ICP) < 22 mmHg The treatment threshold in traumatic brain injury…

…previous angina. Patients should be advised to seek emergency medical assistance rather than self presenting to an emergency department or contacting primary care first. If…

Critical care Myocardial ischemia and infarction Definition and Pathophysiology Cardiogenic shock is a state of inadequate tissue and end organ perfusion caused by cardiac insufficiency…

Arrhythmias and arrhythmology Critical care Definition and pathophysiology Atrial fibrillation (AF) is the most frequent supraventricular arrhythmia in patients with acute coronary syndromes (ACS) and…

Arrhythmias and arrhythmology Critical care Pharmacology & dosing Definition and Pathophysiology Bradycardia and conduction disorders arise from dysfunction within the sinus node, the atrioventricular node (AVN…

Cardiology Critical care Pharmacology & dosing Definition and Pathophysiology In the management of acute heart failure and cardiogenic shock, intravenous vasoactive agents are categorised according to…

Procedurer Two recordings that are performed in primary care but interpreted as specialist investigations. Both fail more often for practical than for medical reasons: the…

…Benign paroxysmal positional vertigo is the commonest cause of vertigo in primary care and one of the few diagnoses that can be cured on the…

…begins long before any retrieval: it begins when someone in the intensive care unit identifies a possible donor and the deceased person's own wishes…

…which must be tapered in a controlled fashion). The management is the opposite in each case. Equivalent doses Agent Equivalent glucocorticoid dose Mineralocorticoid effect Biological…

…Always follow the local protocol for exact infusion rates, electrolyte concentrations and level of care. This quick reference is intended primarily for adults and summarises…

…are taken from the recommendations of Strama Stockholm for the empirical antibiotic treatment of adults in hospital and in residential care homes (SÄBO) 2025/2026…

…else is supportive. But the same compression applied to a limb with arterial insufficiency can cause necrosis and, in the worst case, amputation. The decisive…

…thickness unmeasurable and staging therefore impossible; a superficial punch in a case of bullous dermatosis misses the subepidermal split. Choose the technique according to the…

…Figure 1). Below follows a drug manual for use in the CCU (coronary care unit), ICU (intensive care unit) or ER (emergency room). Careful electrocardiographic…

…ischemic heart disease, heart failure with reduced ejection fraction (HFrEF), and post myocardial infarction (MI) care. Despite their proven morbidity and mortality benefits, their use…

…term relationship with cardiovascular risk is therefore graded, although practical clinical care requires diagnostic and treatment thresholds. The 2024 European guideline defines hypertension as an…

…recovering from myocardial infarction. It extends beyond exercise training to incorporate individualized physical activity counselling, risk factor modification, nutritional care, education, psychosocial support, vocational guidance…

…one of the most common symptoms in the emergency department, as well as in primary health care. The cause (etiology) of chest pain varies according…

…features characteristic of biventricular hypertrophy. Biventricular hypertrophy ECG In case the ECG or other examinations suggest left ventricular hypertrophy (LVH), one should suspect concomitant right…

…effects and lack of compelling data regarding morbidity and mortality benefits, digoxin has been ousted repeatedly from the standard of care for these conditions. However…

…Figure 1). Below follows a drug manual for use in the CCU (coronary care unit), ICU (intensive care unit) or ER (emergency room). Careful electrocardiographic…

…and case fatality in coronary artery disease peaked in the 1970s and have declined steadily ever since. The marked decline in death rates and case…

…congenital malformations leading to an incomplete or absent pericardium. In case of suspicion of pericardial disease, it is important to conduct a careful investigation as…

…1. Sinoatrial arrest. Also note the ST segment elevations (which in this case have no relation to the sinoatrial arrest). As discussed in Chapter 1…

…involve a surgeon The following locations must not be handled routinely in primary care or in the emergency department without contacting the appropriate specialty: Location…

…8. Document the ceiling of care and the decision on intubation early. Initial assessment Confirm that the presentation fits an exacerbation A COPD exacerbation is…

…and is linked to substantial mortality, even though incidence and prognosis vary widely between patient groups and care settings [2]. Practical first actions Do the…

…delaying treatment. 10. Call anaesthetics and intensive care early with life threatening features or an inadequate response. First line treatment is oxygen in hypoxaemia, repeated…

…infection, trauma and metabolic disturbance. 4. Monitoring at the appropriate level of care , with readiness for respiratory support. 5. Treatment of the alcohol use disorder…

…threshold (Hb) : : Most stable adult inpatients, including intensive care 70 g/L Known cardiovascular disease, postoperatively after cardiac surgery 80 g/L Acute coronary syndrome…

…before surgery, or while swelling is progressing. Take care in impaired sensation (neuropathy, spinal cord injury) — the patient does not feel the pressure sore. Preparation…

…catheter). Measurement of central venous pressure and central venous oxygen saturation. Repeated blood sampling during intensive care. Exhausted peripheral venous access during prolonged intravenous therapy…

…every population. Hypoactive delirium is, however, consistently underdiagnosed, and several studies have linked the subtype to high mortality, particularly in intensive care [5]. Suspect hypoactive

…1). What follows is a quick reference for their use in the emergency department, the intensive care or coronary care unit, and the operating theatre…

…high risk of hypoglycaemia 8–12 mmol/L The critically ill patient in intensive care According to the local protocol Avoid tight targets in inpatients…

…The Swedish clinical care programme for bacterial CNS infections states that CT must not be performed before lumbar puncture in suspected bacterial meningitis — not even…

…national or regional poison control centre , which in most countries is staffed around the clock for health care professionals. Contact the centre early in serious…

…after adequate step 1 and step 2 Refractory status: contact anaesthesia, intensive care and neurology; intubate as needed and start anaesthetic treatment with EEG After…

…cost, adherence, pregnancy after the first trimester under specialist care). Rheumatic mitral stenosis with atrial fibrillation. In uncomplicated atrial fibrillation and in ordinary venous thromboembolism…

…adoption has led to standardized reporting of eGFR in clinical laboratories, enhancing consistency in patient care. Non Invasiveness: The calculation relies on readily available clinical…

…rates compared to those with low scores. Monitor Quality of Care : By providing an objective measure of CAD complexity, the SYNTAX Score helps standardize treatment…

…cardiovascular structure and function. Sociocultural factors contribute independently to differences in exposure to risk, access to care, clinical assessment and treatment. These influences are particularly…

…from a more individualized selection strategy. When to Initiate Pharmacological Treatment Lifestyle intervention is an essential component of care. In adults with elevated blood pressure…

…age variations throughout childhood. Clinicians who work in pediatric and neonatal care must have knowledge of age related variations in the ECG, as well as…

…or critical care medicine. Critical Care Reviews Dr Rob Mac Sweeney's superb website which is a must for anyone interested in critical care medicine…

…Consequently, posterior infarction should not be regarded as an isolated electrocardiographic pattern in every case; it may represent the posterior component of a broader infarct…

…for the selected treatment to restore flow. Early reperfusion is therefore the central priority of STEMI systems of care. Fibrinolysis promotes thrombus dissolution by converting…

…their capital letters (Q, R, S), and small waves are referred to by their lower case letters (q, r, s). Figure 5 shows examples of…

…refractory. In this case ( Figure 1 ) it encounters a refractory right bundle branch and therefore the impulse is conducted with right bundle branch block morphology…

…seconds. Case reports have indicated that the risk of high degree AV block and ventricular arrhythmias is greater in patients on digoxin or verapamil, although…