…from symptom onset to recognition and seeking medical assistance. Prehospital assessment, treatment and transport. Diagnostic assessment and initiation of reperfusion therapy. The interval from treatment…

…claudication, the ankle pressure is measured immediately after treadmill walking or after repeated heel raises. A fall of ≥ 20 % after exercise confirms peripheral arterial disease…

…needed to prevent a further fall Level 2, clinically significant < 3.0 mmol/L A seriously low glucose; immediate treatment is required Level 3…

…term relationship with cardiovascular risk is therefore graded, although practical clinical care requires diagnostic and treatment thresholds. The 2024 European guideline defines hypertension as an…

…world: What is the best ECG book? This question is far from trivial and the stakes are high; mastering ECG interpretation will frequently be a…

…112 mmol/L may be relatively unaffected, while a rapid fall from 140 to 125 mmol/L can cause marked symptoms [4]. Grade Plasma sodium : …

…bicarbonate or blood gas, calcium, phosphate, glucose and a full blood count. 5. Take a urine dipstick and, where the cause is unclear or a…

…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…

…needle, 7–9 cm (a spinal needle or the needle from a pericardiocentesis set), 10 mL and 20 mL syringes, a three way tap. A…

… 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…

…The transition from a quiescent plaque to a highly thrombogenic surface occurs via three primary mechanisms: Plaque Rupture: Accounting for 60 70% of ACS presentations…

…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…

…from seizure onset Action : : 0 to 5 minutes ABCDE, start timing, glucose, monitoring, intravenous or intraosseous access, a targeted history At 5 minutes A full…

…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…

…contraindicated at an eGFR < 30 mL/min. Check the full blood count and creatinine when treatment is started, at follow up after one month…

Procedurer Emptying the stomach has gone from routine to exception. Activated charcoal — in Sweden usually called medicinal charcoal — is the first line measure in decontamination…

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…

…sensitivity from at home: less food, more stress, often corticosteroids, often impaired renal function. Prescribe basal insulin, mealtime insulin and the correction dose as three…

Lungmedicin Akutsjukvård Lathundar Key messages Two things set the COPD exacerbation apart from many other causes of acute dyspnoea: oxygen must be titrated cautiously and…

…are elevated. Consequently, congestion may occur across the full range of left ventricular ejection fraction and may result from systolic dysfunction, diastolic dysfunction, or both…

…speckle tracking As previously discussed, the left ventricular wall can be subdivided into three layers: the inner lining ( endocardium ), a thick muscle layer ( myocardium ) and…

…time critical element The diagnosis and the donor care The time from withdrawal of treatment to circulatory arrest Indications An intensive care patient with severe…

…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…

…A full blood count, electrolytes, creatinine, coagulation tests and troponin are taken in parallel but must not delay treatment in a patient without suspected coagulopathy…

…runs away or the patient bleeds. In Sweden the treatment is usually managed from an anticoagulation clinic with dosing support, but whoever starts the drug…

…functional capacity, and health related quality of life substantially influence both cardiovascular risk and the balance between treatment benefit and harm. Prevention in the very…

…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…

…In heavy smokers, cardiovascular risk falls within five years of stopping but may remain elevated thereafter. The overall health benefit is greater still when reductions…

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

…then rebreathes carbon dioxide from the mask Mask with a reservoir 10–15 L/min 60–90 % For acute severe hypoxaemia. Fill the bag before…

…Patient priorities and preferences Patients who are fit and independent generally benefit from guideline directed blood pressure treatment similar to that used in younger adults…

…includes both patients with recovering systolic function and those with deterioration from a previously preserved LVEF. This heterogeneity is relevant to treatment selection and prognosis…

…pauses. In an ICD patient, EMI may be interpreted as ventricular tachyarrhythmia and trigger inappropriate antitachycardia treatment unless detection and therapy are disabled. Conversely, asynchronous…

…triggered activity is a less frequent cause. The atrial rate typically ranges from 120 to 250 beats per minute. To fulfill the diagnostic criteria for…

…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…

…and troponin elevation resembling acute myocardial infarction. These disorders require distinction from true MINOCA because their management is different. Takotsubo syndrome and myocarditis should not…

…Suspected bone marrow metastasis. Assessment of treatment response and measurement of residual disease (MRD). Fever of unknown origin or suspected granulomatous disease with marrow involvement…

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

…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…

…Comment : : : Reticulocytes 20–100 ×10⁹/L Distinguishes a production defect from haemolysis or bleeding Ferritin 15–300 µg/L (women 10–150) An acute phase…

…life threatening clinical syndrome in which increased intrapericardial pressure compresses the heart and impairs ventricular filling. It generally results from accumulation of pericardial fluid, blood…

…specific 99th percentile upper reference limit. It is classified as acute when serial measurements demonstrate a rise and/or fall. A stable elevation indicates chronic…

…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…

…injury from infarction caused by acute ischaemia. Acute myocardial infarction Acute MI requires both: Acute myocardial injury , demonstrated by a rise and/or fall in…

…al. ). Figure 1 presents data from the Swedish Cardiac Arrest Registry, which has recorded causes of cardiac arrest with a separate category for cardiac etiologies…

…CYP2C9 variants) (1 point) E xcessive fall risk (1 point) S troke (1 point) HEMORR₂HAGES Score Risk category Incidence of major bleeding (per 100 patient…

…atrial contraction (premature atrial beat / complex) A premature atrial contraction is produced by an impulse discharged from an ectopic focus located anywhere in the atria…

…The haemodynamic disturbance results from impaired right ventricular contraction and reduced forward flow through the pulmonary circulation. Consequently, left ventricular filling falls and cardiac output…

…the cardiac cycle. It is caused by an impulse discharged from an ectopic focus which may be located anywhere in the ventricles. The ectopic impulse…

…Every seven years HPV, with reflex cytology if HPV positive The interval is counted from the most recent sample analysed for HPV. Invitations are sent…

…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…

…are often mildly elevated. Hence, takotsubo cardiomyopathy cannot be differentiated from ST segment elevation myocardial infarction. Due to their clinical presentation, these patients are immediately…

…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…

…atria begin to contract again. An unsynchronised shock that happens to fall in the T wave can precipitate ventricular fibrillation, and cardioversion of fibrillation of…

…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…

…Non dipping: a nocturnal fall in pressure of < 10% of the daytime value; an independent risk marker. Treatment targets Group Systolic target Diastolic : : : Adults…

…interpreted as specialist investigations. Both fail more often for practical than for medical reasons: the cuff is in the wrong place, the electrodes come off…

…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…