…a lithium battery with a lifespan of 5–10 years. A shorter lifespan can be expected if the pacing requirement is extensive, or if the…

…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…

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

…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…

…Prepare airway equipment and contact anaesthesia early with a prolonged seizure, repeated doses of benzodiazepine, aspiration, hypoventilation, circulatory failure or an anticipated need for anaesthesia…

…threatening arrhythmias or cardiac arrest mechanical complications of acute myocardial infarction. acute heart failure recurrent dynamic ST segment or T wave changes, particularly with intermittent…

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

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

…gas with lactate, two sets of blood cultures, and a culture from the likely focus 0 to 15 min Ringer's acetate for hypotension or…

…retention. Chronic urinary retention with renal impairment or a large residual volume. A need for accurate measurement of urine output in a critically ill patient…

…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…

…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…

…with the forehead against the band and the chin in the rest. Support your working hand against the patient's zygoma or the bridge of…

…in: a reduced level of consciousness with inadequate protective reflexes active major haematemesis severe agitation respiratory failure an anticipated difficult or prolonged endoscopic intervention a…

…new or clearly worse than baseline. Contact relatives, home care services, the residential care home or the previous care provider. 5. Confirm delirium with a…

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

…a risk of blood contact. An alcohol or chlorhexidine swab. Let the skin dry completely before inserting the needle — alcohol carried in with the needle…

…means that the machine emits ultrasound waves with a certain frequency and subsequently records reflected sound waves at double the frequency of the emitted waves…

…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…

…the criteria for activation of the massive transfusion protocol. Plasma and platelets: in ongoing bleeding with coagulopathy, or as part of balanced transfusion in massive…

…the expected course and the possibility of rapid reversal with an antidote. Intubation is recommended for neurological, respiratory or haemodynamic failure that cannot be corrected…

…Salicylate poisoning with symptoms or a rising serum concentration. Alkalinisation increases renal elimination several fold and at the same time reduces the passage of salicylate…

…present with acute chest pain or chest pain equivalent symptoms. The ECG assessment remains necessary even when symptoms have improved by the time of medical…

…3. Give intravenous calcium in the presence of hyperkalaemic ECG changes or arrhythmia. 4. Shift potassium into the cells with insulin and glucose. Add high…

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

…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…

…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…

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

…of: Malaise Fever Pericardial or chest discomfort Leukocytosis Elevated erythrocyte sedimentation rate Pericardial effusion Pericardial pain is often sharp and pleuritic. It may worsen with…

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

…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…

…reserved for patients with a CHA₂DS₂ VA score of 0–1. Check what applies in your own region. Duration above the threshold or unknown: at…

…for example, pulmonary hypertension or pulmonic stenosis. Heart rate . Synchronicity : Optimal contraction requires the majority of all ventricular myocardium to contract simultaneously. For this to…

…Myocardial motion and velocity can be measured with pulsed tissue Doppler (see Pulsed Wave Doppler). Tissue Doppler allows for sampling of specific regions or structures…

…reader may wish to view the video lecture on The ST segment, J point, J 60 point and T wave to facilitate understanding of this…

…or without diabetes Heart failure across the ejection fraction spectrum, according to the guideline key points Patients with renal insufficiency and cardiovascular disease, irrespective of…

…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…

…lower than the velocity of blood flow. Therefore, ultrasound waves reflected from myocardium will have a lower Doppler shift, as compared with waves reflected from…

…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…

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

…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…