…However, refrain from rescue breaths to mitigate the risk of potential contaminants endangering the rescuer. Contact expertise Contact your national or regional poison control centre…

…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…

…Initial diagnosis of STEMI ECG Management Recommendation Level of evidence A 12 lead ECG should be interpreted immediately (within 10 minutes) at first medical contact…

…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…

…benefit of both methods falls steeply with the time since ingestion, and both can harm the patient through aspiration. Contact your national or regional poison…

…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…

…a dialysis fistula. Preparation and equipment Hand disinfection; gloves where there is a risk of blood contact. An alcohol or chlorhexidine swab. Let the skin…

…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…

…or suspected perforation of the tympanic membrane — including a history of grommets, ear discharge or pain on contact with water. A history of ear surgery…

…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…

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

…treatment — contact an orthopaedic surgeon before attempting reduction. Posterior shoulder dislocation, which is often associated with fracture and requires an orthopaedic surgeon. Dislocation of a…

…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…

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

…a pelvic fracture, a straddle injury Relative Recent urethral or prostatic surgery — contact a urologist before attempting Relative A known urethral stricture Relative Acute prostatitis…

…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…

…fluid and early contact with anaesthesia or intensive care Refractory anaphylaxis Persisting airway, respiratory or circulatory compromise despite two adequate intramuscular doses of adrenaline and…

…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…

…interchangeable nozzles, or a cryoprobe for contact technique. Cotton buds for small lesions (these give a more superficial and less controllable depth of freeze). A…

…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…

…cannulae 0 to 10 min A blood gas with lactate, two sets of blood cultures, and a culture from the likely focus 0 to 15…

…the severity of the bleeding 7 Manage antiplatelet drugs according to their indication. Do not routinely stop aspirin given as secondary prevention 8 Contact the…

…ischemia and infarction Definition and pathophysiology Post infarction pericarditis encompasses two temporally and clinically distinct complications of acute myocardial infarction (AMI): Early infarct associated pericarditis …

…and Pathophysiology Posterior myocardial infarction is myocardial necrosis involving the posterior region of the left ventricle, usually as part of an inferoposterior or posterolateral infarction…

…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…

…Myocardial motion concerns the movement of myocardium from one point to another. During the motion, all myocardium within a particular region displays the same velocity…

…causes a rapid influx of sodium and depolarizes the cell. Contractile cells start to contract a few milliseconds after the start of the depolarization and…

Echocardiography Echocardiographic assessment of regional contractile function Systolic ventricular function is one of the strongest predictors of total and cardiovascular mortality. Previous chapters have discussed…

…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…

…blue. The advantage of color tissue Doppler is that all myocardium is analyzed simultaneously, which makes it possible to compare myocardial regions (Figure 2). It…