…straightforward: ultrasound to find the fluid, an insertion site in the left lower quadrant lateral to the rectus sheath, and a cell count plus albumin…

…Retract the foreskin and clean the glans and meatus with the cleansing solution in circular movements from the centre outwards. Change the swab between strokes…

…Chang WT, et al. The effects of calcium and sodium bicarbonate on severe hyperkalaemia during cardiopulmonary resuscitation: a retrospective cohort study of adult in hospital…

Endokrinologi & metabolism Akutsjukvård Lathundar Emergency overview Measure the plasma glucose immediately in everyone with a reduced level of consciousness, seizures, confusion, a change in behaviour…

…conditions characterized by a recent change in symptoms or signs, with or without electrocardiographic changes, and with or without acute elevations in cardiac troponin concentrations…

…shortening (FS) is calculated by measuring the percentage change in left ventricular diameter during systole. It is measured in parasternal long axis view (PLAX) using…

…just proximal to the orifice. The change in flow profile results in the formation of a hemisphere with several layers. Flow velocity is equal within…

…subacute worsening of dyspnoea, cough and sputum in particular that exceeds the patient's normal variation and requires a change of treatment. Common precipitants are…

…attacks of vertigo, seconds to a minute or so, that are provoked by a change of position — turning over in bed, lying down, standing up…

…not met with statins alone. PCSK9 Inhibitors: Added in cases where LDL C remains above the goal despite statin and ezetimibe therapy. Goal: Achieve LDL…

…cm 1.5–2.1 2.2–2.5 2.6–2.9 3.0 RV SIZE AND FUNCTION (MEASURED IN A4C) RV diastolic area…

…patients with recent changes in symptoms or clinical signs, with or without diagnostic electrocardiographic abnormalities and with or without an acute rise in cardiac troponin…

…temporal pattern. Change in frequency, severity, or exercise threshold. Potential anginal equivalents include: Dyspnoea on exertion. Fatigue. Dizziness during exertion. Discomfort in the arm, jaw…

…troponin released from injured cardiomyocytes at substantially lower concentrations than earlier generation assays. They can identify troponin concentrations in approximately 50–95% of healthy individuals…

…must be incorporated. In symptomatic individuals without known CAD, newer clinical prediction algorithms are preferred over older approaches based solely on age, sex and typicality…

…conducted with right bundle branch block morphology. This is an example of how changes in the length of the cardiac cycle causes aberration. Figure 1…

…reflector is in motion, however, then the frequency of the reflected sound waves will differ from the emitted sound waves. The change in frequency is…

…elderly patients with altered valves, patients with valve prostheses or other cardiac devices (pacemaker, CRT, ICD). In addition to staphylococcus aureus , hemolytic streptococci and pneumococci…

…branch blocks and alter their appearance. Some patients develop nonspecific intraventricular conduction defects without any change in their QRS appearance. Such conduction delays may be…

…In older, malnourished, amputee or muscle wasted patients, an apparently normal creatinine may therefore correspond to markedly impaired renal function [3]. Urine output can change…

…vestibular syndrome Brief attacks, usually lasting seconds, reproducibly triggered by a particular change in position Benign positional vertigo, orthostatic hypotension Dix Hallpike, supine roll test…

…two adequate intramuscular doses of adrenaline and initial fluid treatment Adrenaline infusion and advanced resuscitation in a monitored setting The grade can change within minutes…

Klinisk kemi & laboratoriemedicin Akutsjukvård Lathundar Basic principle Interpret the blood gas in the same order every time. Skipping a step is a common reason why…

…previous punctures: change side, and avoid irradiated fields. Preparation and equipment Informed consent, current full blood count and coagulation screen, medication list. Chlorhexidine in alcohol…

…a small change in T4 produces a large change in TSH. During acute illness the TSH can be falsely low or high in the absence…

…Statements made verbally to the next of kin. Since the change in the law in 2022, the next of kin no longer have a right…

Akutsjukvård Psykiatri Lathundar Delirium in older adults: quick reference A quick reference for ward and on call physicians: recognise hypoactive delirium, stabilise the patient, work…

…blood pressure in combination with new or progressive acute target organ damage. Common manifestations are hypertensive encephalopathy, intracerebral haemorrhage, acute coronary syndrome, acute left ventricular…

…Conversely, a rapid rise in blood pressure from a previously low level can cause organ damage at lower values, for example in pregnancy, acute glomerular…

…corticosteroid is tapered. The dose must come down in parallel, otherwise hypoglycaemia will follow. Discharge without a plan. Document what has been changed, who is…

…or nerves, and the landmark — the posterior corner of the acromion — is easy to palpate even in a large patient. The anterior approach, just lateral…

…otoscopy: a slight change of pressure with the bulb shows whether the tympanic membrane is mobile — an immobile membrane suggests fluid in the middle ear…

…dose change can reach the patient the same day the result arrives. 3. Reduce to 5 mg (two tablets) on days 1 and 2 in…

…de Pointes severe ziprasidone mesylate ZIPRASIDONE MESYLATE ZIPRASIDONE MESYLATE Arrhythmia wp less change in QTc from baseline mild PENICILLIN G PROCAINE PENICILLIN G PROCAINE PENICILLIN…

…and hemodynamic instability. Evaluation and physical examination The objective of decongestion is clinical euvolemia rather than an isolated numerical change in weight. Assessment should integrate…

…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…

…more events than a major reduction in risk among a small number of high risk individuals. This principle underlies the population approach to cardiovascular prevention…

…cardiogenic shock. UA itself is defined by a recent change in the pattern of myocardial ischaemia rather than by a particular symptom intensity alone. The…

…dysfunction, and hypercoagulability [1] [2] . Mechanical stasis in AF is most pronounced in the left atrial appendage (LAA). The LAA is a highly trabeculated, windsock…

…aortic stenosis As aortic stenosis progresses, pressure conditions on the left side change dramatically, including in the left ventricle, left atrium, aorta and coronary arteries…

…with left ventricular systolic function. EAT = v max /time Fractional shortening (FS) Fractional shortening (FS) is calculated by measuring the change (% reduction) in left…

…shows characteristic ECG changes in left ventricular hypertrophy (LVH) and right ventricular hypertrophy (RVH). Note that ventricular hypertrophy is primarily evident in the chest leads…

…ventricle with varying orientation. This organization allows the left ventricle to contract in a highly sophisticated and effective way (Figure 1). Myocardial fibers adjacent to…

…reader will notice that most of these drugs are contraindicated in patients with structural heart disease, as well as patients with reduced left ventricular function…

…left ventricular hypertrophy may instead display normalization of secondary T wave inversions (lead V5, V6, aVL, I). ECG in moderate hyperkalaemia Previously mentioned ECG changes…

…of the ECG changes or arrhythmias are unique to digoxin. One should always suspect digoxin as the trigger of an arrhythmia (in patients using digoxin…

…as in Figure 1 . Any type of infarction may cause pathological R wave progression. However, the specificity for pathological R wave progression is considerably lower…

…of the ECG – from heart rhythm to QTc interval – the most prominent and reliable ECG changes occur in the ST segment and the T wave…

ECG Myocardial ischemia and infarction Myocardial ischemia: cellular changes, ECG signs and development of infarction Like all other cells in the human body, cardiac myocytes…

Referensvärden A child's ECG changes continuously with age: the heart rate, the electrical axis and the waveform in the newborn differ markedly from adult…

ECG Myocardial ischemia and infarction T wave changes in acute myocardial infarction & ischemia A thorough discussion regarding the physiology of the T wavewas previously provided…

…myocarditis and perimyocarditis: ECG changes and clinical features The pericardium is a double walled sac in which the heart and the roots of the great…

Njurmedicin Akutsjukvård Lathundar Emergency management in brief The intensity of treatment is governed by ECG changes, symptoms, the rate of rise, renal function and the…

…types of cardiomyopathies Cardiomyopathy implies that the myocardium is structurally and functionally altered, and the pathological changes are not explained by coronary heart disease, hypertension…

ECG Hypertrophy and dilatation ECG and clinical characteristics in right ventricular hypertrophy (RVH) Figure 1. ECG changes seen in left ventricular hypertrophy (LVH) and right…

…in any of the following: A systolic blood pressure < 90 mmHg caused by the arrhythmia. Ongoing myocardial ischaemia with chest pain and ECG changes…

ECG Exercise stress test Definition and clinical role Exercise electrocardiographic testing is a standardized assessment in which a patient performs progressively increasing external work, usually…

…in the systemic circulation (and thus the aorta) is relatively low. Figure 2. The fetal circulation. Therefore, the right ventricle is larger than the left…

…ST segment elevation in the standard 12 lead ECG. Instead, the infarct related electrical changes may be recorded indirectly as reciprocal abnormalities in the anterior…

…cardiac output . Systolic blood pressure increases when cardiac output increases. Diastolic blood pressure is not affected by changes in cardiac output. Hence, diastolic blood pressure…