…emergency number. Contact the nearest intensive care unit with expertise in toxicological emergencies. Antidote Administer the specific antidote promptly upon suspicion of poisoning. Decontamination Disrobe…

…begins in parallel with the diagnostic work up. Obtain an interpretable 12 lead ECG within 10 minutes of first medical contact, attach continuous rhythm monitoring…

…blood count or contact with the patient's own clinic delay empirical antibiotics [1]. A practical target: give the first dose of broad spectrum antibiotics…

…instability or cardiogenic shock recurrent or ongoing chest pain refractory to medical treatment life threatening arrhythmias or cardiac arrest mechanical complications of acute myocardial infarction…

…version 4 of 27 February 2024. The local stroke protocol and immediate contact with the on call stroke consultant or the thrombectomy centre take precedence…

…but accounts for a minority of cases Hypoactive Lethargy, slow responses, reduced speech, immobility, poor food intake, reduced eye contact Common and particularly easy to…

…the visual acuity before anything else is done. The second most important is to look for signs of perforation — Seidel's sign, an irregular pupil…

…Contact your national or regional poison control centre before you decide, not afterwards. Indications Medicinal charcoal is given after the ingestion of a potentially toxic…

…or a very strong clinical suspicion. 3. Give intravenous calcium in the presence of hyperkalaemic ECG changes or arrhythmia. 4. Shift potassium into the cells…

… gloves where there is a risk of blood contact. An alcohol or chlorhexidine swab. Let the skin dry completely before inserting the needle — alcohol carried…

…products and contact with the blood bank. 3. Secure large bore access, or rapid central access, but do not delay transfusion or control of the…

…Diabetes, immunosuppression A risk of necrotising otitis externa Anticoagulant treatment Bleeding into the ear canal Previous radiotherapy to the head and neck Fragile skin, poor…

…oxygen on a reservoir mask — this markedly shortens the half life of carbon monoxide. Contact your national or regional poison control centre regarding hyperbaric treatment…

…a marked risk of aspiration, or failure that is not rapidly reversed by an antidote B Respiratory rate, saturation, chest movement and a blood gas…

…clinically or radiologically confirmed dislocation of the shoulder, elbow, finger, patella, jaw or hip prosthesis. A dislocation with neurovascular compromise or skin tenting — reduce promptly…

…intracranial aneurysm Contact the responsible specialist An aortic aneurysm 6 cm Relative — avoid forced manoeuvres An ongoing respiratory infection with a risk of transmission Until…

…cannot be obtained quickly and parenteral treatment is needed. Prepare airway equipment and contact anaesthesia early with a prolonged seizure, repeated doses of benzodiazepine, aspiration…

…fold and at the same time reduces the passage of salicylate into the central nervous system. Contact your national or regional poison control centre for…

…impairment or a large residual volume. A need for accurate measurement of urine output in a critically ill patient. Perioperatively and postoperatively in longer procedures…

…leads are introduced into one of the larger veins (typically the subclavian vein) and guided further down to the heart where they contact the endocardium…

…9. Request ultrasound of the kidneys and urinary tract when a postrenal cause cannot confidently be excluded. 10. Contact nephrology early in severe, progressive or…

…Anaphylaxis is a rapidly developing systemic hypersensitivity reaction that can cause life threatening compromise of the airway, breathing or circulation. Skin symptoms may be absent…

…call coagulation service Always in parallel: mechanical control of bleeding, tranexamic acid where it is not contraindicated, and contact with the on call coagulation service…

…haemorrhage control) planned in advance. A history of a severe transfusion reaction: contact transfusion medicine before transfusing again. Preparation and equipment Compatibility testing Test What…

…experienced practitioner in selected cases, but surgery is the standard. Dark skin: a risk of permanent hypopigmentation. Areas with poor circulation, above all the lower…

…rule out a possible donor on your own on grounds of age or medical history — contact the transplant coordinator and let the assessment be made…

…capillary refill, skin temperature, urine output, respiration, chest findings, MAP and the response to every intervention Within 60 min Contact intensive care in shock, rapidly…

…Give small boluses, for example 250 to 500 mL, with immediate reassessment of the blood pressure, pulse, peripheral perfusion, mental state and chest findings. Avoid

…Clinical presentation and symptoms The characteristic clinical syndrome consists of: Malaise Fever Pericardial or chest discomfort Leukocytosis Elevated erythrocyte sedimentation rate Pericardial effusion Pericardial pain…

…primarily in the context of suspected acute coronary syndrome and acute myocardial ischaemia. Patients may present with acute chest pain or chest pain equivalent symptoms…

…dislodgement, lead fracture or inadequate myocardial contact. It may also be due to the low amplitude (voltage) of the potentials generated by activated myocardium. Functional…

…position of the transducer. The ultrasound gel is important because it maximizes the contact surface between the transducer and the skin. Generous use of gel…

…begin to contract again. An unsynchronised shock that happens to fall in the T wave can precipitate ventricular fibrillation, and cardioversion of fibrillation of unknown…

…and pharmacological basis Sodium glucose cotransporter 2 (SGLT2) inhibitors are a class of oral agents initially developed for glucose lowering in type 2 diabetes mellitus …

…onset of the T wave ( Figure 1 A ). The plateau phase has a long duration which enables the majority of the ventricular myocardium to contract…

…contract in several directions simultaneously. The subendocardium is the muscle layer closest to the endocardium. The subendocardium has the poorest prerequisites in the case of…

…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…

…electrical potentials of the conduction system are much too small to be detected by skin electrodes; the ECG presents the electrical activity of the atrial…

…well with the severity and extent of ischemia. In the setting of moderate ischemia, the myocardium becomes hypokinetic, meaning that the ischemic segments contract less

…myocardium to contract simultaneously. For this to be possible, the right leg must be intact. In the case ofblockade of the right bundle of His…

…sound waves reflected from myocardium have high amplitude. This is due to the high density of myocardium. It follows that myocardium generates reflections with high…