…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…

…while the typical local signs of inflammation may be faint or absent. Take cultures immediately, but never let sampling, imaging, the blood count or contact…

…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…

…still. A deeply embedded body reaching the stroma or deeper. The absence of a slit lamp — the cornea should not be instrumented without magnification. With…

…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…

…body. 6. Check the plasma potassium after about 1 hour and follow the plasma glucose closely for at least 6 hours after insulin. 7. Contact…

…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…

…centre , which in most countries is staffed around the clock for health care professionals. Contact the centre early in serious, unusual or unclear poisoning, with…

…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…

…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…

…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…

…a valid blood group, give group O RhD negative blood (always RhD negative to women of childbearing age) while awaiting the result. Equipment A large…

…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 …

…first medical contact and interpreted within a target of 10 minutes. Prehospital ECG acquisition can shorten the time to diagnosis and facilitate triage of patients…

…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…

…thumb and the forefinger, while remaining fingers stabilize the grip. The transducer tends to glide out of position due to the gel. One or two…

…sync mode no shock at all is then delivered while the patient deteriorates. Indications Emergency, irrespective of duration and anticoagulation status: Tachyarrhythmia with haemodynamic compromise…

…activity Attenuation of oxidative stress, inflammation and fibrosis Reduction in body weight and haemoglobin A1c Increased uricosuria, with plasma uric acid reduction of approximately 10…

…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…

…abundance of ions, enabling them to function as electrical conductors. As a result, the electrical currents produced by the myocardium are transmitted through the body…

…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…