…home care services, the residential care home or the previous care provider. 5. Confirm delirium with a structured instrument , for example the 4AT or the…

…aged 1–10 years is unknown: estimate it as (age in years + 4) × 2 kg , but use a length based tool if one is available…

ECG Myocardial ischemia and infarction Use of ECG in acute coronary syndromes & chest pain patients An ECG must be performed on all patients seeking medical…

…diabetes care in the hospital. Endocrine Society clinical practice guideline on the management of hyperglycaemia in hospitalised adults. The summary of product characteristics for each…

…all in the afternoon and evening. See the quick reference on inpatient insulin therapy Peptic ulcer A proton pump inhibitor with concomitant NSAID use or…

…hypertension: a raised office reading but normal readings at home or on 24 hour recording. Masked hypertension: normal in the office but raised outside it —…

…to ischemic myocardium (i.e an increase in blood flow in the ischemic area!) [2]. Take home message: in the setting of acute coronary syndromes…

…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…

…for 5 minutes. The back and arm should be supported, with the cuff at heart level. A standard cuff measuring approximately 12–13 cm in…

…times as great a risk of sudden cardiac death. For readers interested in recognizing early repolarization, I recommend a recent consensus document written by MacFarlane…

…tolerated doses, including a diuretic appropriate for kidney function. In patients with an estimated glomerular filtration rate below 30 mL/min/1.73 m², an…

…Otoscopy: an otoscope with a charged battery and clean disposable specula in several sizes. Use the largest speculum that will fit — it gives the most…

…primary care personnel and home visits may reduce rehospitalization for recurrent ischaemia and infarction. Clinical Presentation and Symptoms Cardiac rehabilitation is initiated in patients recovering…

…severe hypothermia No signs of life <24 °C Actions in accidental hypothermia with cardiac arrest or cardiopulmonary depression Use HOPE Score to assess the prognosis…

…Intraosseous access (absolute, for the bone in question): A fracture of the bone to be punctured, or a major injury proximal to the puncture site…

…are taken from the recommendations of Strama Stockholm for the empirical antibiotic treatment of adults in hospital and in residential care homes (SÄBO) 2025/2026…

…GWTG RI) was 25% in 2017. Location and witnesses About 60% of all out of hospital cardiac arrests are witnessed, which is fundamental for survival…

Myocardial ischemia and infarction Definition and Clinical Significance In stent restenosis (ISR) is recurrent narrowing within a previously implanted coronary stent. It represents a form…

…Oxycodone 20 mg 10 mg Hydromorphone 4 mg 2 mg Ketobemidone 30 mg 10 mg Fentanyl patch: 12 micrograms/hour corresponds approximately to 25–30…

…Reported relative effects include: Approximately 11% reduction in cardiovascular events in a meta analysis of primary prevention trials involving individuals with an estimated 10 year…

…transcending their original roles as glucose lowering agents to become essential tools for cardiovascular risk reduction, offering profound benefits in major adverse cardiovascular events (MACE)…

…of a structure appearing in front of the mirror is shown. The mechanism behind mirror image artifacts is similar to that of reverberations. Figure 4…

…been considered for its prognostic implications. Clinicians often check pupil size and reactivity as part of initial and ongoing evaluations of patients in cardiac arrest…

…4 points make LVH probable. 5 points make LVH very likely. Romhilt Este's score system Points Any of the following: R or S in…

…which is reflected in ST T changes on the ECG. (B) Note that the reference level for measuring deviation (elevation or depression) of the ST…

…10. Call anaesthetics and intensive care early with life threatening features or an inadequate response. First line treatment is oxygen in hypoxaemia, repeated doses of…

…ideal weight + 0.4 x (actual weight minus ideal weight). Red flags and pitfalls Creatinine is a poor measure in the frail and the elderly…

…with a vasoconstrictor for the nose: lidocaine 4 % with oxymetazoline 0.5 % on pledgets. Mineral oil or lidocaine to kill an insect in the ear…

…a modified release preparation is started in an opioid naive patient, or when a conversion between drugs is made without reduction for incomplete cross tolerance…

…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…

…or STEMI. Aspirin 75–162 mg once daily is described as an acceptable secondary prevention range in chronic coronary disease. For prolonged treatment, doses of…

Arrhythmias and arrhythmology Critical care Definition and pathophysiology Atrial fibrillation (AF) is the most frequent supraventricular arrhythmia in patients with acute coronary syndromes (ACS) and…

…For recurrent symptomatic bradycardia, temporary or permanent pacing may be required. However, transcutaneous pacing in the setting of cardiac arrest has not demonstrated clear benefit…

Cardiology Clinical medicine Definition and Clinical Context Blood pressure management in older adults must account for chronological age, biological age, frailty, multimorbidity, cognitive status, functional…

…become progressively more complex. Older adults, often defined in cardiovascular practice as those older than 75 years, are not a homogeneous population: biological age, frailty…

…prevalence of asymptomatic atherosclerotic cardiovascular disease (ASCVD) than the general population. The evidence for premature atherosclerosis is particularly strong in RA and SLE. Ankylosing spondylitis…

…XX and XY individuals and are reflected in cardiovascular structure and function. Sociocultural factors contribute independently to differences in exposure to risk, access to care…

…although some series report 10–20%. Other life threatening cardiopulmonary conditions account for approximately 5% of presentations in some populations. Despite this relatively low prevalence…

…reserved for low output and hemodynamic instability. Evaluation and physical examination The objective of decongestion is clinical euvolemia rather than an isolated numerical change in…

…lowering treatment for patients with chronic coronary syndrome, acute coronary syndrome (ACS), atherosclerotic peripheral arterial disease, and other very high risk settings described in the…

…history remains clinically useful for estimating risk. Pathophysiology and genetic principles Penetrance and variable expression A pathogenic variant does not invariably result in clinical disease…

…variant in asymptomatic athletes with no significant family history? A: Mobitz Type II 2nd AV block B: Prolonged QT interval (QTc ≥ 480 ms for females…

…In the setting of acute coronary syndrome, AF is the most frequent supraventricular arrhythmia. It may predate the coronary event, be detected for the first…

…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…

…score has been the foundational tool for assessing thromboembolic risk. However, recent epidemiological data have prompted a divergence in international guidelines regarding the role of…

…al Adrenaline (epinephrine) No 112 Perkins et al Table 1. Number needed to treat (NNT) for interventions in cardiopulmonary resuscitation. AED = automatic external defibrillator…

…JJ, Jesty SA, et al. Use of CPR in hemorrhagic shock, a dog model. J Trauma Acute Care Surg 2016;81:27 33. Watts S…

…response system using your local emergency number. Contact the nearest intensive care unit with expertise in toxicological emergencies. Antidote Administer the specific antidote promptly upon…

…is common to use the term perimyocarditis . Hemodynamic effects of pericardial effusion and cardiac tamponade Intrapericardial pressure increases as fluid accumulates in the pericardial space…

…severity) which may compensate for the inability to reach their maximal heart rate. Ultimately, the specificity of exercise stress testing is lower in the elderly…

…been completed. Furthermore, the blood pressure lowering effect persists for a duration of 3 to 4 days post infusion, thereby providing extended therapeutic benefits. 2…

…as in Figure 1 . Any type of infarction may cause pathological R wave progression. However, the specificity for pathological R wave progression is considerably lower…

Cardiology Indications for pharmacologic agents Pharmacologic stress tests are indicated in the following scenarios: Inability to exercise due to physical limitations. Contraindications to exercise, such…

…Current guideline criteria for ischemic ST segment depression: New horizontal or downsloping ST segment depressions ≥0,5 mm in at least two anatomically contiguous leads…