…of the heart to provide blood flow appropriate to tissue requirements unless filling pressures are elevated. Consequently, congestion may occur across the full range of…

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

…of both hypovolaemia and venous congestion. 4. Take an urgent panel: creatinine, urea, sodium, potassium, bicarbonate or blood gas, calcium, phosphate, glucose and a full…

…wishes are properly established. Two things determine the outcome — that the confirmation of death is carried out in a formally unimpeachable way, and that the…

Procedurer The value of the exercise test lies not in ST depression alone but in the overall picture : exercise capacity, symptoms, blood pressure response, heart…

…sample. Indications Diagnostic paracentesis: Newly detected ascites — always. Every admission of a patient with known ascites. Clinical deterioration in a cirrhotic patient with ascites: fever…

…access, a targeted history At 5 minutes A full, adequate dose of a benzodiazepine About 10 minutes Repeat the benzodiazepine once if the seizure persists…

…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…

…classification is clinically useful but should not be regarded as a series of completely discrete diseases. Heart failure extends across the full range of LVEF…

…approximately 5 to 10 seconds may precede the full tachycardia. It is characterized by short, rapid bursts of atrial activity. In the majority of cases…

…Non hyperemic pressure ratios (instantaneous wave free ratio [iFR], resting full cycle ratio [RFR], and related resting indices) simplified the procedure by removing the need…

…the ceiling of care. Signs of a serious condition Finding Significance : : Inability to speak in full sentences Marked work of breathing Use of accessory respiratory…

…oedema and mucus plugging. Expiratory flow limitation causes air trapping and dynamic hyperinflation. The consequences are increased work of breathing, exhaustion and, in the most…

…done without losing time. 7. Perform urgent CT of the brain and CT angiography from the aortic arch to the vertex. 8. Contact the thrombectomy…

…without delay, in any of the following: A systolic blood pressure < 90 mmHg caused by the arrhythmia. Ongoing myocardial ischaemia with chest pain and…

…What usually ruins the examination is not the technique but the handling of the specimen — an aspirate that clots before the smears are made is…

…dialysis catheter, not an ordinary triple lumen catheter). Measurement of central venous pressure and central venous oxygen saturation. Repeated blood sampling during intensive care. Exhausted…

Procedurer For many patients a gynaecological examination is associated with a sense of exposure, and technically correct performance is only half the task. The examination…

…or a very strong clinical suspicion. 3. Give intravenous calcium in the presence of hyperkalaemic ECG changes or arrhythmia. 4. Shift potassium into the cells…

…L) — choose the subcutaneous route if possible, otherwise give IM with a fine needle and 5 minutes of compression. Anticoagulant treatment is not in itself…

…a laryngeal mask is inserted even with a full stomach. Preparation and equipment A laryngeal mask of the correct size plus one size above and…

…a full blood count, INR, APTT and fibrinogen. 7. Give tranexamic acid where it is indicated. 8. Proceed in parallel to definitive control of the…

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

…afterwards whether a nerve injury was caused by the injury or by the treatment. Indications A clinically or radiologically confirmed dislocation of the shoulder, elbow…

…Warfarin has a narrow therapeutic index, a half life of several days and more than a hundred clinically relevant interactions. What determines whether the treatment…

…In stable patients, it is advisable to add therapy with beta blocking agents before full target doses of ACE inhibitors are reached. Medication doses should…

…records are incomplete. A full device check should be available within the recommended interval before elective surgery. In the absence of malfunction, a pacemaker should…

…full recovery of contractility may take hours to days. It is generally stated that myocardium resists 20 minutes of severe hypoxia before cell death begins…

…out of 100 cases had full recovery. More recent studies has reported mortality rates reaching 4%. ECG in takotsubo cardiomyopathy (broken heart syndrome) 80% of…

Referensvärden Reference ranges are statistical: by definition they encompass 95 % of a healthy reference population, which means that one healthy value in twenty falls outside…

…An unsynchronised shock that happens to fall in the T wave can precipitate ventricular fibrillation, and cardioversion of fibrillation of unknown duration without anticoagulation can…

…rise and/or fall in cardiac troponin with at least one value above the 99th percentile upper reference limit; and Clinical evidence of acute myocardial…

…with the same risk as manifest hypertension. Non dipping: a nocturnal fall in pressure of < 10% of the daytime value; an independent risk marker…

Endokrinologi & metabolism Akutsjukvård Lathundar Emergency overview Measure the plasma glucose immediately in everyone with a reduced level of consciousness, seizures, confusion, a change in behaviour…

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

…genotypes. These medications mitigate adrenergic stimulation, thereby decreasing the likelihood of arrhythmia onset. However, beta blockers do not fully eliminate the risk. In LQT3 patients…

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

…an exaggerated inspiratory fall in systemic systolic blood pressure, termed pulsus paradoxus. Tamponade is therefore characterized haemodynamically by elevation and near equalization of diastolic pressures…

…age, may not be fully captured by conventional risk scores and may be the first clinically important manifestation of an otherwise unrecognized inflammatory disease. Epidemiology…

…the 99th percentile upper reference limit (URL). The injury is considered acute if there is a documented rise and/or fall of cTn values. However…

…of several weeks, improvement with anti inflammatory treatment, and the tendency to recur all support an immunopathological mechanism. The precise cause, however, is not fully…

…complications fall into two broad categories: Electrical complications , particularly ventricular arrhythmias. Mechanical or pump failure complications , including heart failure and cardiogenic shock. Most out of…

…AI). ECG interpretation requires a comprehensive understanding of cardiovascular pathophysiology and electrocardiology. Unfortunately, numerous books and online resources fall into the trap of oversimplification. Physicians…

…by a rise and/or fall in cTn with at least one value above the 99th percentile URL; and Clinical evidence of acute myocardial ischaemia …

…has not fully repolarized by the time the next impulse reaches the ventricles, the impulse will be blocked at that point. The length of the…

…such that the vein can be fully compressed in the supine position in a cardiac arrest. For women beyond the 20 th week of pregnancy…

…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 the preferred level of care for the absolute majority. The CCU may be suitable for stable (hemodynamically and respiratory) and fully conscious patients who…

CPR It is commonly stated that approximately 80% of all cardiac arrests are caused by acute or chronic coronary artery disease, with the latter being…

…to calculate stroke volume, cardiac output, pressure conditions, severity of stenoses and regurgitations, etc . These calculations are based on simple mathematical equations, which are based…

…more time to fill the ventricles with blood (increased ventricular filling). Persons with premature beats might perceive this as palpitations, because of the stronger ventricular…

…more time to fill the ventricles with blood (increased ventricular filling). The person with premature beats might perceive this as palpitations, because of the stronger…

…the patient fell asleep and got up. Holter ECG and longer rhythm monitoring Indications Palpitations, presyncope or syncope of suspected arrhythmic origin. Assessment of rate…

…fall of ≥ 20 % after exercise confirms peripheral arterial disease. Toe brachial index (TBI). The digital arteries rarely calcify, which makes toe pressure the method of…

…Oral vancomycin (only for C. difficile) is likewise dosed independently of renal function. Require drug concentration monitoring Drug Comment : : Vancomycin (intravenous) Loading dose by weight…

…be used for an initial assessment of pH and the metabolic component, but it should not be regarded as fully interchangeable with an arterial sample…

…A patient with a chronic plasma sodium of 112 mmol/L may be relatively unaffected, while a rapid fall from 140 to 125 mmol/L…

…line is necessary to achieve an optimal result. Overview of vasopressors and inotropes Vasoconstriction Vasodilatation Positive inotropy Phenylephrine Vasopressin Midodrine Noradrenaline Adrenaline, high dose Dopamine…

…reconsider the pain mechanism instead of continuing to increase the dose. The level of sedation is scored on a four point scale: 0 fully awake…

…be prescribed as one: with an indication, a route of administration and a target range for the saturation . What usually goes wrong is not that…