…movement; those that fail usually do so because the patient tenses up with pain, or because the operator pulls harder rather than more slowly. The…

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

…patients with symptoms suggestive of acute myocardial infarction and at least one of the following criteria present: haemodynamic instability or cardiogenic shock recurrent or ongoing…

…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…

…diagnostic ECG, the ECG must be repeated, particularly with ongoing or recurrent pain [1,3,4]. This quick reference gives internationally established doses. Drug availability…

…of inflammation may be faint or absent. Take cultures immediately, but never let sampling, imaging, the blood count or contact with the patient's own…

…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…

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

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

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

…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…

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

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

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

…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…

…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…

…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 …

…Confirm the potassium with a repeat sample, but do not delay treatment when there are ECG changes, circulatory compromise or a very strong clinical suspicion…

…Contact the centre early in serious, unusual or unclear poisoning, with modified release preparations, mixed poisoning, pregnancy, children, a need for an antidote or dialysis…

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

…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…

…collapse or impaired consciousness Adrenaline, oxygen, intravenous access, fluid and early contact with anaesthesia or intensive care Refractory anaphylaxis Persisting airway, respiratory or circulatory compromise…

…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…

…the massive transfusion protocol. Plasma and platelets: in ongoing bleeding with coagulopathy, or as part of balanced transfusion in massive haemorrhage. Transfusion thresholds in the…

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

…rasping, or grating sound produced by contact between inflamed pericardial layers. It may have up to three components per cardiac cycle and is often best…

…may manifest as reciprocal ST segment depression rather than apparent ST segment elevation. Posterior involvement is commonly associated with inferior or lateral myocardial infarction. Consequently…

…This may be due to lead dislodgement, lead fracture or inadequate myocardial contact. It may also be due to the low amplitude (voltage) of the…

…national or regional poison control centre, and activate the emergency medical response system using your local emergency number. Contact the nearest intensive care unit with…

…phenomenon. Preparation and equipment Liquid nitrogen in a flask (−196 °C) and a cryospray gun with interchangeable nozzles, or a cryoprobe for contact technique. Cotton…

…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…

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

…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…

…failure with reduced ejection fraction (HFrEF), with or without diabetes Heart failure across the ejection fraction spectrum, according to the guideline key points Patients with…

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

…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…

…10. Contact nephrology early in severe, progressive or diagnostically unclear AKI. Definition and staging according to KDIGO Acute kidney injury is present when at least…

…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…