…error A capillary glucose is sufficient to start emergency treatment, but abnormal or unexpected values should be confirmed with a laboratory analysed plasma glucose when…

…for dialysis ECG changes or serious neuromuscular symptoms mean a high risk even if the plasma potassium is below 6.5 mmol/L. Conversely, patients…

…investigation and drug treatment must proceed simultaneously. Do not wait for laboratory results, CT or EEG before the first dose of benzodiazepine is given. Airway…

…clinical setting. Values obtained in the emergency department for acute dyspnoea should not be transferred directly to patients with less acute outpatient symptoms. Natriuretic peptides…

…arrest (OHCA) who achieve ROSC in the emergency room (ER) are transferred to the intensive care unit (ICU), coronary care unit (CCU), or catheterization laboratory…

…when encountering a patient with chest pain the primary task is to exclude or verify the following potentially life threatening causes of chest pain: Ischemic…

…patients with inferior myocardial infarction, consider connecting V3R and V4R to detect concomitant right ventricular infarction. IIa B Routine blood sampling for serum markers is…

…or intravenous treatment. Some patients with acute pain, anxiety, or distress have transient BP elevation that improves when the precipitating state resolves. The distinction is…

…reference This is a practical quick reference for emergency physicians in suspected acute ischaemic stroke. It covers time windows, indications and contraindications for intravenous thrombolysis…

Esmolol Drug Esmolol Brand names Brevibloc ® Indications Short term control of ventricular rate (including perioperative tachycardia) and hypertension (including hypertensive emergency, perioperative hypertension). Mechanism…

…and CME site for anasthesiologists. Site is maintained and updated actively, which means it deserves a bookmark if your into anasthesia or critical care medicine…

Hydralazine Hydralazine is not preferred for hypertensive emergencies due to the high risk of reflex sympathetic stimulation. Drug Hydralazine Brand names Apresoline ®, Bidil ®…

…®, Rogitine ® Indications Hypertensive crisis. Mechanism of action Phentolamine is a non selective alpha adrenergic blocker. Phentolamine reduces blood pressure while increasing catecholamine activity…

…for example hypoglycaemia, poisoning, stroke, meningitis and a postictal state. 3. Check a repeat plasma sodium if the result is unexpected or does not fit…

…For injection: the corticosteroid drawn up in its own syringe, so that the same needle can stay in place when the syringe is changed after…

…if the MAP remains below 65 mmHg or the hypotension is marked. Do not wait for a central venous catheter Continuously Reassess the mental state…

…of the treatments is provided below. Figure 1. Management of acute bradycardia in the emergency setting. In the event of manifest or impending circulatory collapse…

…lasting longer than 30 seconds or requiring termination earlier due to hemodynamic collapse [4] . Sustained VT is a medical emergency that universally warrants acute intervention…

…recovery. A patient who stops at a low workload with a fall in blood pressure is a high risk patient even with normal ST segments…

…possibly cardiac , or non cardiac . The term “atypical” is discouraged because it may understate the possibility of ischaemia. A focused history should establish: Quality of…

…drug manual is provided for use in patients with hypertensive emergency (also referred to as hypertensive crisis or malignant hypertension ). Hypertensive emergency is defined as…

…drug manual is provided for use in patients with hypertensive emergency (also referred to as hypertensive crisis or malignant hypertension ). Hypertensive emergency is defined as…

… Anaphylaxis is a clinical diagnosis. Treat as anaphylaxis in any of the following: 1. Acute onset of skin or mucosal symptoms , for example generalised urticaria…

…adrenaline auto injector and written instructions. Patients taking beta blockers may respond poorly to adrenaline. If there is no response, give glucagon 1–5 mg…

…limit is 24 hours, not 48. The 2024 ESC guidelines and several Swedish clinical knowledge resources have tightened the former 48 hour rule for patients…

…message Fever in a neutropenic patient is an emergency. Infection can progress rapidly, while the typical local signs of inflammation may be faint or absent…

…lower threshold for provocation, or symptoms that awaken the patient from sleep. Initial symptoms of NSTEMI and UA may be similar. NSTEMI is diagnosed when…

…Nuances: While typical angina is defined by these characteristics, the presentation can be highly variable, particularly in females, the elderly, or patients with diabetes [4…

…Patients with hypotension, marked low output, or persistent severe symptoms require close monitoring and consideration of invasive haemodynamic assessment when precise measurements are needed to…

…presenting to an emergency department or contacting primary care first. If ischaemic discomfort persists, emergency medical services should be called. Patients who have been prescribed…

…with extensive atherosclerosis and frequently occurs in older patients with multiple vascular comorbidities. An isolated PAU is one without associated IMH, dissection, or saccular aneurysm…

…low risk PE includes stable patients who are not low risk but have either RV dysfunction or elevated biomarkers, or neither of these abnormalities in…

…In patients with acute pericarditis, tamponade is uncommon when the cause is viral or idiopathic but is more frequent when the underlying cause is non…

…follow cardiac surgery, coronary angiography or other invasive procedures, and affected patients may be relatively painless compared with those with spontaneous dissection. Clinical manifestations may…

…is adequate. For example, a patient with acute graft occlusion may report an abrupt reduction in walking distance before claudication, accompanied by moderate pain or…

…provide specific details regarding the physical examination or general evaluation of patients with bradycardia. Diagnostics Electrocardiographic assessment is fundamental to the diagnosis and management of…

…without a significant dynamic change is consistent with chronic myocardial injury. Non ischaemic conditions, including myocarditis, rapid ventricular rate atrial fibrillation, marked anaemia, hypertensive emergency…

…a stable patient — awake fibreoptic intubation or anaesthetic back up is then the right course, not RSI. Assess the airway first LEMON for a rapid…

…calcium channel blocker. Clevidipine is highly selective for vascular smooth muscle cells and has little or no effect on myocardial contractility or conduction. Clevidipine reduces…

…• In patients with pheochromocytoma, cocaine or methamphetamine overdose, prior treatment with alpha blockade is necessary before administering labetalol (risk of elevating blood pressure in these…

…Edema. Dizziness. Caution Should be used cautiously in patients with myocardial ischemia and/or heart failure. Nicardipine doses and administration in hypertension (hypertensive crisis/emergency).

…of hypertension, including hypertensive emergency. Mechanism of action • Systemic Dopamine 1 (D1) receptor agonist. • Lowers blood pressure while maintaining or increasing kidney perfusion. Effects Dopamine…

…important precautions. A hypertensive emergency is defined by a markedly raised blood pressure in combination with new or progressive acute target organ damage. Common manifestations…

…induce severe hypotension. • Clonidine is not recommended in most patients with severe cardiovascular disease or in those who are otherwise haemodynamically unstable. The benefit of…

…should never be used for mor than 10 minutes. Administer sodium thiosulfate (cyanide into thiocyanate) and terminate infusion of nitroprusside if cyanide toxicity is suspected…

…emergency room: a very large or deep abscess, a markedly unwell patient with fever and systemic upset, suspected necrotising soft tissue infection, a child who…

…down by three adults. Procedure Batteries and magnets A button battery in the nose or the ear canal is an emergency, not a finding that…

…which is not supported by evidence. The patient may need active treatment and prompt follow up, but not necessarily acute normalisation in the emergency department…

…tachycardia, ventricular fibrillation This manual presents recommendations for the management of ventricular tachyarrhythmias (VT, VF). It is primarily intended for use in an emergency setting…

…Brand names Vasotec IV ® Indications Hypertension and hypertensive emergency. Acute left ventricular failure. Mechanism of action Enalaprilat is the active metabolite (ester) of enalapril…

…Figure 1). Below follows a drug manual for use in the CCU (coronary care unit), ICU (intensive care unit) or ER (emergency room). Careful electrocardiographic…

Nitroglycerin Patients using nitroglycerin regularly may have developed tolerance and require higher doses, alternatively nitroprusside to achieve desirable blood pressure lowring effect. Drug Nitroglycerin Brand…

…tachycardia, ventricular fibrillation This manual presents recommendations for the management of ventricular tachyarrhythmias (VT, VF). It is primarily intended for use in an emergency setting…

…Figure 1). Below follows a drug manual for use in the CCU (coronary care unit), ICU (intensive care unit) or ER (emergency room). Careful electrocardiographic…

…the emergency medical system (EMS), as well as the hospital cardiac arrest team (CAT) and intensive care units and other units caring for resuscitated patients…

…lead ECG within 10 minutes. 3. Attach defibrillator pads if the patient is unstable or at marked risk of arrhythmia. 4. Take a full blood…

…The need for central access is not in itself an indication for emergency insertion in an unstable situation: intraosseous access or a large bore peripheral…

…protocol. Usually a bolus followed by repeated doses or an infusion Suspected adrenal crisis Give the corticosteroid immediately. Do not wait for laboratory results. Take…

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

…Figure 1). What follows is a quick reference for their use in the emergency department, the intensive care or coronary care unit, and the operating…