…In impaired consciousness or DKA: remove the pump and change to an infusion or injections Drugs for type 2 diabetes in inpatients Agent The acutely…

…not treated away. Incision and drainage is the treatment; antibiotics are normally neither necessary nor sufficient in an uncomplicated cutaneous abscess in an otherwise healthy…

…tachycardia is always considered pathological and the underlying cause must be investigated. Pain, infections, medications, fever, hypovolemia, dehydration, anemia, hyperthyroidism and myocarditis are common etiologies…

…seizures, and infections. However, the underlying evidence for many of the recommendations is based on few randomized trials and the evidence is often conflicting. Many…

…pericardial effusion and cardiac tamponade Small amounts of pericardial effusion may not cause any ECG changes. Significant pericardial effusion may bring about the following ECG…

…The following functions are attributed to the pericardium: The pericardium serves as a barrier to infections. The pericardium reduces friction between the ventricles and surrounding…

…are viral infection, bacterial infection and air pollution, but often no definite trigger can be identified [1,2]. Ask specifically about: Onset and time course…

…by Direct criteria: clinical neurological examination and, where needed, four vessel angiography Indirect criteria after circulatory arrest, following a five minute no touch period The…

…coronary arterial tree after selective intracoronary contrast injection under fluoroscopy. The procedure is performed by advancing guidewires and diagnostic catheters from a percutaneous arterial access…

…IA, IC and III antiarrhythmics. Tricyclic antidepressants . Lithium. Cholinesterase inhibitors. Methyldopa. Reserpine. Clonidine. Conditions Myocardial ischemia, myocardial infarction (can cause permanent bradycardia, particularly anterior infarctions)…

…infarctions 100 times smaller than what was possible to detect in year 2000. This explains why there has been a 20% increase in NSTEMI and…

ECG Myocardial ischemia and infarction Pathological Q waves are evidence of myocardial infarction Myocardial infarction – particularly if extensive in size – typically manifests with pathological Q…

…including carbamazepine, theophylline and quinine. Repeated dosing may also be appropriate after large ingestions of modified release preparations. Contraindications Measure Contraindication : : Medicinal charcoal A reduced…

…then 100 mg × 1 5–7 days Epiglottitis and other severe upper airway infection cefotaxime 1–2 g × 3 IV Depends on the diagnosis Always…

…system. The underlying pathophysiology varies widely and may involve intrinsic cardiac disease, extrinsic systemic conditions, or pharmacologic effects. Inflammatory heart disease, caused by infections (viral…

…of infection on the flap is called vegetation. As a rule, some kind of damage to native (own) valves is required to become vulnerable and…

…the opening pressure in suspected idiopathic intracranial hypertension. Therapeutic drainage in idiopathic intracranial hypertension and in assessment before shunt surgery. Contraindications Clinical signs of herniation —…

…healthy individuals. Infections and the risk of acute coronary syndromes It is known that the risk of developing acute coronary syndromes increases during infections, including…

…Consequently, the decision to prescribe colchicine requires attention to the balance between reduction in ischaemic events and possible infectious or other non cardiovascular adverse outcomes…

…by streptococcal infections (group A Streptococcus ). Rheumatic heart disease can occur at any age and multiple valve lesions are common (typically the aortic and mitral…

…pericarditis is infections, in particular viral infections. This explains why pericarditis may affect individuals of all ages. However, a wide range of local and systemic…

…and medications : A wide range of diseases and medications may cause sinus tachycardia; e.g congestive heart failure, lung disease (e.g COPD), fever, infections…

…fluid and a vasopressor according to the sepsis pathway when needed 9 Contact the haematologist or oncologist. Contact an infectious diseases physician early in a…

…to be given: hold the needle still, change the syringe and inject. The injection should go in easily. Resistance means the tip is in tissue…

…The commonest cause of wound infection is retained contamination, not poor suture technique — and the commonest cause of permanent loss of function is a tendon…

…3. Rapid identification of seizures, delirium tremens, infection, trauma and metabolic disturbance. 4. Monitoring at the appropriate level of care , with readiness for respiratory support…

…aortic balloon pump. Assessment of stroke volume variation as part of fluid management. Contraindications Infection, burn or trauma over the insertion site. Insufficient collateral circulation…

…skin incision with the scalpel. 5. Aspiration: advance the needle with the stylet in place perpendicular to the bone surface, angled slightly anteriorly and medially…

…never happens, and to make sure the catheter does not become the patient's next focus of infection. Indications Infusion of vesicant solutions: vasopressors, concentrated…

…acid Folate 7 nmol/L Electrolytes and renal function See the renal parameters for the eGFR stages and albuminuria. Inflammation and infection Test Reference Comment :…

…doses or an infusion Suspected adrenal crisis Give the corticosteroid immediately. Do not wait for laboratory results. Take a serum cortisol and ACTH first only…

…anaphylaxis, deep neck infection, an expanding haematoma, facial trauma. An anticipated course requiring a secured airway — transfer, heavy sedation, surgery — and cardiac arrest. Contraindications There…

…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…

…Intramuscular injection in marked coagulopathy or thrombocytopenia (< 50 ×10⁹/L) — choose the subcutaneous route if possible, otherwise give IM with a fine needle and…

…exostoses Narrow and hard to reach Ongoing otitis externa Pain, spread of infection A small or uncooperative child Movement causes injury Preparation and equipment Otoscopy…

…blood gas and electrolytes can be interpreted, but some laboratories do not accept marrow blood in their analysers — check locally. Contraindications Peripheral venous cannula: Infection…

…on a table for diagnostic and therapeutic aspiration; for drain insertion the supine position is used with the arm abducted and the hand behind the…

…parallel and must not wait for complete diagnostic certainty. Sepsis is defined as life threatening organ dysfunction caused by a dysregulated host response to infection…

…not an alternative to it. See the separate guide to joint aspiration and injection. Indications Condition Injection site Comment : : : Subacromial bursitis, rotator cuff syndrome The…

…respiratory infection with a risk of transmission Until symptom free Haemoptysis of unclear cause Until investigated Relative obstacles also include dementia, marked hearing loss and…

…Maximum infusion rate 25 mg/hour. Adverse effects Tachycardia. Flushing. Headache. Angina pectoris. Caution Heart failure. Angina pectoris (ischemic heart disease). Hydralazine doses and administration…

…minutes Duration of action 2 to 4 hours Delivery IV Dose Can be given as repeated intravenous bolus injections or as a constant dose infusion…

…with several simultaneous renal insults. Infection, hypovolaemia, cardiac dysfunction, haemodynamic instability, anaemia and other nephrotoxic exposures may contribute to tubular injury, making attribution to contrast…

Cardiology Pharmacology & dosing Definition and therapeutic rationale Inclisiran is a liver directed small interfering RNA (siRNA) designed to reduce production of proprotein convertase subtilisin/kexin…

…and does not delay treatment Saturation Give oxygen in hypoxia, not routinely to a normoxic patient Temperature Treat fever and look for an underlying infection…

…tract infection. At an eGFR <30 mL/min the antibacterial effect is lost. Dosed independently of renal function Doxycycline, erythromycin, clindamycin, metronidazole, moxifloxacin and fusidic…

Procedurer The single most important step in any eye injury is to measure and document the visual acuity before anything else is done. The second…

…and measure the ankle brachial index with Doppler. 4. Culture only in the presence of clinical signs of infection — all chronic wounds are colonised, and…

…unit and which reference system your own laboratory uses before applying it. The D dimer is raised in pregnancy, malignancy, infection, surgery, trauma and old…

…report. A shave biopsy of a pigmented lesion that turns out to be a melanoma can make the Breslow thickness unmeasurable and staging therefore impossible…

…Chronotropic support is given as an infusion of isoprenaline, adrenaline or dopamine according to local practice, and does not replace pacing when the patient is…

…and acquired factors may interact in its development. PAH may be idiopathic, heritable, drug associated, or associated with conditions such as systemic sclerosis, HIV infection…

…infection or other circumstances that may affect cessation or treatment monitoring. Single question screening can identify unhealthy drug use requiring counselling regarding cardiovascular effects and…

…Acute infection Renal or hepatic impairment Hypothyroidism Vitamin D deficiency Concomitant interacting medications The SLCO1B1 rs4149056 polymorphism is associated with higher statin concentrations and may…

…great medical inventions of the 20th century. Cardiac pacing has evolved from a hazardous experiment in the 1930s, to a routine, safe, and sophisticated treatment…

…respond to maximal ACTH stimulation, and it is rarely the injection itself that determines whether the result can be interpreted. What decides that is whether…

…Dose Bolus injection : 5 to 15 mg every 5 to 15 minutes as necessary. Continuous infusion: Start infusion at 0.1 mg/min and increase…

…ischemia and infarction Acute myocardial infarction (AMI) always affects the left ventricle Myocardial infarction is virtually synonymous with left ventricular infarction . All myocardial infarctions affect…

…transdermal Dose Injection IV: • 150 μg in 1 ml vial. Dilute with 10 ml of normal saline and give by slow injection over 5…

…necrosis, bleeding, or pleural incision may expose cardiac antigens and initiate an inflammatory response. The presence of antibodies directed against cardiac tissue, the latent interval…