…always Pulsus paradoxus above 10 mmHg A fall in systolic blood pressure during inspiration; one of the most useful signs Low voltage on the ECG…

…on a single eGFR. Step 1: confirm the course and assess severity Establish the baseline Look for previous creatinine values in the record, preferably from…

…with elevation of their diastolic pressures. Right sided filling becomes increasingly dependent on the fall in intrathoracic pressure during inspiration. The inspiratory increase in right…

…will fall outside. The ranges below are guide values for adults. The method and the laboratory determine the range — always use the range printed on…

…numerous books and online resources fall into the trap of oversimplification. Physicians, nurses, paramedics and physician assistants who rely on such books will realize their…

…HEMORR₂HAGES bleeding risk score is a clinical tool developed to assess the risk of major bleeding in patients with atrial fibrillation (AF) on anticoagulation therapy…

…documented rise and/or fall of cTn values. However, myocardial injury alone is an entity in itself and may arise from non ischaemic cardiac conditions…

…cuff compression should be avoided in the acute phase. A leg that has recently been operated on, is in a cast or has extensive wounds…

…sets of blood cultures from separate peripheral punctures. Also culture from a central line if one is present 4 Take a full blood count with…

… or angina occurring after a recent MI. Myocardial injury is separate from MI. It refers to cardiac troponin release that does not fulfil the criteria…

…This distinction supports a risk based approach because cardiovascular benefit from blood pressure reduction may also occur in selected people whose pressure is elevated but…

…trials, the field has transitioned from a predominantly pharmacological strategy to one that heavily integrates early catheter ablation and sophisticated device therapy [1] [2] . This…

…alert value < 3.9 mmol/L but at least 3.0 mmol/L Prompt action is needed to prevent a further fall Level 2…

…NSTEMI and UA hinges entirely on the presence of myocardial necrosis. NSTEMI is confirmed by a typical rise and/or fall of high sensitivity cardiac…

CPR The course from sudden cardiac arrest (SCA) to death follows a pathophysiological process that affects the effectiveness of the interventions. Numerous studies demonstrate that…

…with haemodynamic compromise, whatever the current haemoglobin — haemoglobin falls late in acute haemorrhage and a normal value does not exclude significant blood loss. Massive haemorrhage…

Endokrinologi & metabolism Lathundar An inpatient has a different insulin sensitivity from at home: less food, more stress, often corticosteroids, often impaired renal function. Prescribe basal…

…A documented decision on the ceiling of care. Signs of a serious condition Finding Significance : : Inability to speak in full sentences Marked work of breathing…

…with the sinus P wave. The appearance depends on the location of the ectopic focus from which the impulse is discharged. If the impulse is…

…discussion. A premature ventricular complex is recognized on the ECG as an abnormal and wide QRS complex occurring earlier than expected in the cardiac cycle…

…be considered. The doses and Swedish thresholds below are based on the national guideline for the management of reperfusion treatment in ischaemic stroke, Nationell arbetsgrupp…

…Scars, hernia or visible abdominal wall collaterals (caput medusae) Puncture at least a few centimetres away from them Full bladder Have the patient void, or…

…The two pathways DBD DCD : : : Full name Donation after death by neurological criteria (total brain infarction) Donation after circulatory death Starting point A ventilated patient…

…Sampling for a suspected sexually transmitted infection — although chlamydia and gonorrhoea can be tested on urine or a self taken vaginal sample without a speculum…

…Observational data from trauma suggest a lower overall mortality after such protocols are introduced, although the effect on 24 hour mortality is uncertain and the…

…60–90 % For acute severe hypoxaemia. Fill the bag before applying the mask Venturi mask 2–15 L/min depending on the valve 24, 28…

…of falls; anaemia and a known gastrointestinal source are investigated before starting. A referral or notification to the anticoagulation clinic, and a decision on who…

…mg/g—or both. The eGFR is generally estimated from serum creatinine using the Chronic Kidney Disease Epidemiology Collaboration (CKD EPI) equation, incorporating relevant demographic…

…regarded as a series of completely discrete diseases. Heart failure extends across the full range of LVEF, and echocardiographic measurement is subject to meaningful variability…

…likelihood of clinically significant EMI is generally low, particularly with bipolar electrocautery performed away from the device and with monopolar electrocautery below the umbilicus. Nevertheless…

…depending on the ventricular response. The ECG in ectopic atrial rhythm and atrial tachycardia A regular rhythm with P waves that differ in contour from…

…Figure 1). Myocardial fibers adjacent to the endocardium are longitudinally oriented (from base to apex) and yield a longitudinal shortening (Figure 1A), which means that…

…result from mechanisms that render chest compressions ineffective. For instance, a traumatic hemorrhage can deplete intravascular volume to such an extent that chest compressions fail…

…intravenous beta blocker Digoxin In heart failure or hypotension, or as an add on Slow onset. Dose reduction in renal failure and in old age…

…compression. Infection in the skin overlying the puncture site. Previous pelvic irradiation on the intended side (yields fibrotic, unrepresentative marrow — choose the other side). A…

…5. At the same time, start treatment that eliminates potassium from the body. 6. Check the plasma potassium after about 1 hour and follow the…

…Indeed, the greatest opportunities for survival exist during the first few minutes from collapse. Table 1 shows the number needed to treat (NNT) for various…

…a dose of 30 ml/kg. Should fluid resuscitation fail to maintain a mean arterial pressure (MAP) above 65 mmHg, consider the initiation of vasopressor…

…mechanism. Sequential activation implies that the atria are activated first and they fill the ventricles with adequate volumes of blood before ventricular contraction commences. To…

…is most pronounced and extends towards the penumbra zone (the outermost and less ischemic area), which may receive oxygen from collateral vessels. In cardiac arrest…

…Lyon et al: Current state of knowledge on Takotsubo syndrome: a Position Statement from the Taskforce on Takotsubo Syndrome of the Heart Failure Association of…

…the "can't intubate, can't oxygenate" situation there are no contraindications — a laryngeal mask is inserted even with a full stomach. Preparation and equipment…

…falls, and functional deterioration may have greater consequences in frail patients. Clinical Assessment Frailty and Functional Status Treatment decisions should not be based on age…

…fail to demonstrate plaque disruption, intraluminal thrombus, or dissection. Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) can reveal lesions that are not apparent on…

…Left main stenosis Known — perform the test only on a clear indication and with full preparedness Moderate to severe aortic stenosis without symptoms Individual assessment…

…patients with diabetes and anyone with dizziness Definitions White coat hypertension: a raised office reading but normal readings at home or on 24 hour recording…

Procedurer Two things determine whether the procedure is safe: that synchronisation really is switched on when the shock is delivered, and that the thromboembolic risk…

…and clinical role Exercise electrocardiographic testing is a standardized assessment in which a patient performs progressively increasing external work, usually on a treadmill, while symptoms…

…an opioid can be given for the pain, but the effect on the bowel must be taken into account). Known allergy to the preparation — rare…

…autonomic reflexes that influence the haemodynamic result. Reflex tachycardia is the rule after a rapid fall in blood pressure. Drug Indications Dosing α1 β1 β2…

Akutsjukvård Psykiatri Lathundar Delirium in older adults: quick reference A quick reference for ward and on call physicians: recognise hypoactive delirium, stabilise the patient, work…

…minutes. 3. Attach defibrillator pads if the patient is unstable or at marked risk of arrhythmia. 4. Take a full blood count, electrolytes, creatinine, glucose…

…that bleeds because the edges are held apart. A wound through the full thickness of the dermis, particularly over joints and in cosmetically sensitive areas…

…decline in blood oxygen saturation ensues. Within 1 2 minutes, oxygen saturation falls to approximately 60%, leading to unconsciousness. The myocardium responds to hypoxia by…

…departments — follow local protocol. Severe lung disease or a contralateral pneumothorax: avoid the subclavian and jugular routes on the healthy side, since a pneumothorax there…

…Anticoagulant treatment is not in itself a bar to vaccination. Relative: Lymphoedema or previous axillary clearance on the same side. A paretic limb — poorer absorption…

…Clinical Presentation and Symptoms The source material does not provide specific information on the clinical presentation and symptoms of the underlying conditions for which ACE…

…with plasma uric acid reduction of approximately 10% to 15% Possible effects on erythropoietin activity and erythropoiesis SGLT2 inhibition may also activate adenosine 5′ monophosphate…

…TdP is drug dependent, ranging between 1% and 8% for Class III antiarrhythmic agents depending on the specific drug and dosage [1]. Acute Management and…

…attack Acute severe attack Life threatening attack : : : : Speech Full sentences Cannot complete a sentence in one breath Single words or unable to speak Position and…