…pulse is weak, after previous failed attempts, or in children. A rolled towel to place under the wrist, and tape to secure the hand. Positioning:…

…and pathophysiology Lipid lowering therapy is a central component of cardiovascular prevention, particularly in patients with established atherosclerotic cardiovascular disease (ASCVD), chronic coronary syndrome (CCS)…

…3. Give oxygen in hypoxaemia. 4. Start an inhaled short acting β2 agonist immediately. 5. Add ipratropium in a severe or life threatening attack. 6…

…and most serious dosing errors arise at the dilution step, not in the choice of dose. Paediatric doses are calculated on actual body weight unless…

…administration of norepinephrine. All patients with severe acute heart failure who receive levosimendan should be monitored invasively (e.g. arterial line, PiCCO, central venous catheter…

…acquired). The VT is polymorphic with a gradual alteration in the QRS amplitude, often with twisting of the QRS complex around the isoelectric line. Most…

…Definition and pharmacological basis Ezetimibe is a non statin lipid lowering agent that inhibits the Niemann–Pick C1 like 1 (NPC1L1) transporter in the intestine…

…acquired). The VT is polymorphic with a gradual alteration in the QRS amplitude, often with twisting of the QRS complex around the isoelectric line. Most…

…including non calcified plaques that are not directly visualized by calcium scoring. In contrast, coronary CT angiography (CCTA) can characterize both calcified and non calcified…

Echocardiography Continuous Wave Doppler In continuous wave Doppler (CW Doppler), ultrasound waves are continuously emitted from the transducer and the reflections of these waves are…

…lateral resolution as explained in Figure 3. Figure 3. Axial and lateral resolution of the ultrasound image. Axial resolution is constant along the ultrasound lines…

…still used in clinical practice. M mode provides a one dimensional view of all reflectors (i.e structures reflecting ultrasound waves) along one ultrasound line…

…in some cases up to 6 hours or more. Discuss this with the poison control centre. Gastric lavage is considered only after a life threatening…

Hematologi & onkologi Infektionssjukdomar Lathundar Key message Fever in a neutropenic patient is an emergency. Infection can progress rapidly, while the typical local signs of inflammation…

…R. Open chest versus closed chest cardiopulmonary resuscitation in trauma patients with signs of life of life hospital arrival upon arrival: a retrospective multicenter study…

…line, on level with V4. V6: placed on level with V4 and V5, in the mid axillary line. V4R: placed on the right medioclavicular line…

…To calculate flow across a valve, the Doppler line is placed in the valve orifice. The ultrasound machine displays the recorded flows as the spectral…

Neurologi Akutsjukvård Lathundar Definition and aims of treatment Convulsive status epilepticus in adults is present with: an ongoing generalised tonic clonic seizure lasting at least…

…Its primary clinical utility in contemporary practice is late line therapy for patients who remain profoundly symptomatic despite optimal neurohormonal blockade and adequate volume control…

…risk of CAD. In patients with a high to very high risk of CAD, invasive coronary angiography is the first line option. Coronary computerized tomography…

…also used frequently in the emergency setting to control ventricular rate during supraventricular tachycardias (e.g.atrial fibrillation). Because digoxin may cause life threatening arrhythmias…

…below). This chapter presents recommendations for conducting a standard transthoracic echocardiographic (TTE) examination and it is in line with guidelines issued by ASE, EACVI and…

…resulting in subendocardial ischemia and comparatively milder symptoms. For the same reason, patients with STEMI are at higher risk of life threatening ventricular arrhythmias in…

…shows the most fluid, usually in the scapular line one to two intercostal spaces below the upper border of the fluid, but never below the…

…of known HPA suppression to determine whether replacement can be stopped. The test is not the first line investigation in a suspected acute crisis. There…

Akutsjukvård Lathundar Basic principle Anaphylaxis is a rapidly developing systemic hypersensitivity reaction that can cause life threatening compromise of the airway, breathing or circulation. Skin…

…arrest and in the uncontrolled emergency — but it should be changed or removed once the situation has stabilised. Preparation and equipment A central line set…

…and continuous monitoring. An arterial line is often appropriate when very rapid or precise control is required, for example in acute aortic syndrome, marked neurological…

…vasodilatation in the coronary, renal, cerebral and mesenteric vessels. Few Dopamine — intermediate dose Cardiogenic shock. Vasodilatory shock. Heart failure, acute or chronic. Bradycardia (second line…

…the patient gets too little oxygen but that the prescription has no target — the nasal cannula stays in place for days without anyone asking why…

…Transcutaneous pacing takes seconds to start and can keep a patient alive until a transvenous lead is in place — but only if it is working…

…2 3 LQTS Risk model, a validated tool designed to estimate the 5 year risk of life threatening arrhythmic events in individuals with LQT1, LQT2…

…2 3 LQTS Risk model, a validated tool designed to estimate the 5 year risk of life threatening arrhythmic events in individuals with LQT1, LQT2…

…pronounced increase in SVR. As medium dose, and additionally severe hypertension (caution if patient on nonselective beta blockers). Dobutamine Cardiogenic shock Bradycardia (second line therapy…

…pronounced increase in SVR. As medium dose, and additionally severe hypertension (caution if patient on nonselective beta blockers). Dobutamine Cardiogenic shock Bradycardia (second line therapy…

…syndrome are fairly specific to the disorder, provided that the clinical characteristics are in line with the disorder. There are however other disorders that may…

…likely that the coming guidelines by the American Heart Association (AHA) and American College of Cardiology (ACC) will be in line with the European guidelines…

…Pain). As in patients with STEMI, those with NSTEMI and unstable angina are at considerable risk of developing life threatening ventricular arrhythmias (ventricular tachycardia, ventricular…

…likely that the coming guidelines by the American Heart Association (AHA) and American College of Cardiology (ACC) will be in line with the European guidelines…

…clinical picture are sufficient for a treatment decision. Systemic thrombolysis is the first line treatment in high risk embolism, unless there is an absolute contraindication…

…crisis [1,2]. A hypertensive emergency means a markedly raised blood pressure together with ongoing or new organ damage in which immediate, controlled blood pressure…

…be measured in the sitting position . 2. Identify the level. Palpate both iliac crests and draw an imaginary line between them. The line crosses the…

…in the first instance. Give small boluses, for example 250 to 500 mL, with immediate reassessment of the blood pressure, pulse, peripheral perfusion, mental state…

…vascular structures is limited. CCTA has become an important first line investigation for selected patients with suspected coronary artery disease (CAD), particularly those with stable…

…remain central. Diagnostic Strategy Initial 12 lead ECG The resting 12 lead ECG is the first line diagnostic test in suspected acute coronary syndrome. It…

…PR interval is assessed in order to determine whether impulse conduction from the atria to the ventricles is normal. The flat line between the end…

…into the mediastinum. The anterior superior iliac spine is a second line alternative in marked obesity or when the supine position is necessary. After previous…

…Paroxysmal atrial fibrillation in patients with severe symptoms, provided that first line therapies have failed and the patient does not have structural heart disease or…

…patient instead. Refractory shock in which the bradycardia and reduced contractility of hypothermia are not tolerated. A decision to withhold further life sustaining treatment. Preparation…

…when additional LDL C reduction is required, including in patients with atherosclerotic cardiovascular disease (ASCVD) or heterozygous familial hypercholesterolaemia. The broader therapeutic principle is that…

…normal. The isoelectric (flat) line between the end of the P wave and the start of the QRS complex is called the PR segment. The…

…ultrasound is constant in the body. The investigator specifies where the measurement should be performed by moving the sample volume (SV) along the Doppler line…

…of this discussion. The bottom line, however, is of direct clinical relevance and states that increased afterload results in a slower relaxation. Any condition leading…

…220 msec. The PR segment is the flat line between the end of the P wave and the start of the QRS complex. The PR…

…arrest (OHCA), it can be used in any setting until advanced cardiac life support (ACLS) can be initiated by healthcare professionals. The purpose of basic…

CPR Time is the most critical factor for survival in cardiac arrest. Life saving interventions must be initiated momentarily to maximize the probability of survival…

…Signaling: These agents inhibit pro inflammatory pathways (NF κB and MAPK) in vascular smooth muscle cells, reducing cytokines like IL 6 and TNF α…

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

…may provoke life threatening ventricular arrhythmias. Patients with previous acute coronary syndromes (ACS) Exercise stress testing is routinely performed after acute myocardial infarction in order…

…limited life expectancy. Available randomized evidence has not demonstrated that frailty weakens the cardiovascular benefits of blood pressure lowering among the frailer participants enrolled in…