…before organ preserving treatment is started, and a conversation conducted with time, clarity and respect is also what makes the decision hold afterwards. Organ preserving…

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

…clinical judgement [5]. Recognising sepsis Suspected or confirmed infection together with new organ dysfunction must raise the suspicion of sepsis. The patient need not have…

Info This page summarises the most current recommendations for the management of acute coronary syndromes with persistent ST segment elevations (i.e STEMI, ST segment…

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

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

…than baseline. Contact relatives, home care services, the residential care home or the previous care provider. 5. Confirm delirium with a structured instrument , for example…

…response system using your local emergency number. Contact the nearest intensive care unit with expertise in toxicological emergencies. Antidote Administer the specific antidote promptly upon…

…grouping ABO and RhD typing. Requires two samples drawn on two separate occasions with a separate identity check each time Always, once per patient if…

…by contact between inflamed pericardial layers. It may have up to three components per cardiac cycle and is often best heard at end expiration with…

…when the shock is delivered, and that the thromboembolic risk has been dealt with before the atria begin to contract again. An unsynchronised shock that…

…pharmacological basis Sodium glucose cotransporter 2 (SGLT2) inhibitors are a class of oral agents initially developed for glucose lowering in type 2 diabetes mellitus (T2DM…

…muscle fibers are organized into several sheets wrapping around the ventricle with varying orientation. This organization allows the left ventricle to contract in a highly…

…but occasionally flat. Lead V1 : Inverted or flat T wave is rather common, particularly in women. The T wave inversion is concordant with the QRS…

…fibers are organized into several sheets that wrap around the ventricle with varying orientation. As explained below, this enables the ventricle to contract in several…

Procedurer Oxygen is a drug and must be prescribed as one: with an indication, a route of administration and a target range for the saturation…

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

…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…

…and dangerous in a few. The male urethra is about 25 cm long with two curves and a prostate that can grip; the female urethra…

…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…

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

…examinations In small children, it is possible to perform the entire transthoracic echocardiography (TTE) with the child in the supine position. This is possible due…

…The local stroke protocol and immediate contact with the on call stroke consultant or the thrombectomy centre take precedence where there is a discrepancy or…

…leader and one person responsible for recording the transfusions, the sampling, the incoming products and contact with the blood bank. 3. Secure large bore access…

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

…main principle behind artificial pacemakers; i.e applying an external electrical current that depolarizes cells in contact with the lead tip, and thus generate an…

…instrumental removal: Suspected penetrating injury or an intraocular foreign body — shield the eye with a rigid shield, give systemic antibiotics and contact an ophthalmologist urgently …

…and record an ECG. 2. Confirm the potassium with a repeat sample, but do not delay treatment when there are ECG changes, circulatory compromise or…

…is staffed around the clock for health care professionals. Contact the centre early in serious, unusual or unclear poisoning, with modified release preparations, mixed poisoning…

…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…

…Contact your national or regional poison control centre for advice on the treatment threshold and on whether haemodialysis should be considered. Rhabdomyolysis with marked elevation…

…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…

…secondary prevention 8 Contact the endoscopist and the consultant on call early. In cirrhosis or suspected variceal bleeding, also contact a gastroenterologist with hepatology expertise…

…consideration of additional leads. Evaluation and Physical Examination At first medical contact, assessment should occur concurrently with acquisition of the initial ECG. Evaluation includes prompt…

…etc. Most cases of malfunction are associated with the electronics in the pulse generator or dislodgement or fracture of the leads. External causes are less…

…has turned white. Contact technique with a cryoprobe gives a deeper and more controlled freeze on flat surfaces; spray technique is better on irregular surfaces…

…half of the heart, it is important to familiarize yourself with the principles of hemodynamics and conditions prevailing on the right side. Echocardiography is the…

…waves reflected from myocardium will have a lower Doppler shift, as compared with waves reflected from erythrocytes. (2) Whereas reflections from erythrocytes have low amplitude…

…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…

…a postrenal cause cannot confidently be excluded. 10. Contact nephrology early in severe, progressive or diagnostically unclear AKI. Definition and staging according to KDIGO Acute…

…Contractile cells start to contract a few milliseconds after the start of the depolarization and they start relaxing a few milliseconds after the repolarization is…