…a monoclonal antibody directed against interleukin 1β, provided proof of concept but was not developed for routine coronary prevention because of fatal infections and…

…infection cefotaxime 1–2 g × 3 IV Depends on the diagnosis Always assess the severity clinically, whatever the DS CRB65 score. Urinary tract Diagnosis Agent…

…native (own) valves is required to become vulnerable and contaminated by bacteria . Infections are difficult to heal because the heart valves are not vascularized and…

…opposite in each case. Equivalent doses Agent Equivalent glucocorticoid dose Mineralocorticoid effect Biological half life : : : : Hydrocortisone (cortisol) 20 mg Marked Short, 8–12 hours Prednisolone…

…varies widely and may involve intrinsic cardiac disease, extrinsic systemic conditions, or pharmacologic effects. Inflammatory heart disease, caused by infections (viral, bacterial, protozoal, fungal, parasitic)…

…Agent Onset Duration Comment : : : : Lidocaine 10 mg/mL Rapid 1–2 hours The standard choice Lidocaine 10 mg/mL with adrenaline 5 µg/mL Rapid…

…work of breathing with impending exhaustion. Threatened airway obstruction: inhalation injury, anaphylaxis, deep neck infection, an expanding haematoma, facial trauma. An anticipated course requiring a…

…unless there is an absolute contraindication. The agent and dose are according to the local protocol. Alternatives when there is a contraindication: catheter directed treatment…

…an underlying infection Swallowing Keep the patient nil by mouth until swallowing has been assessed The plasma glucose is normally the only test result that…

…rapid acting) Corrects a currently high value As required, in addition to the mealtime dose Never stop basal insulin in a person with type 1…

…inclisiran permits subcutaneous administration only twice yearly, an important practical distinction from therapies requiring monthly or biweekly injections. Inclisiran is used as an adjunct to…

…anaphylaxis, ceftriaxone, ferric carboxymaltose Rapid, 10–20 min Subcutaneous (SC) Insulin, low molecular weight heparin, GLP 1 analogues, methotrexate, biological agents, adrenaline (second choice) Slower…

…tumour types are not a bar). Untreated generalised infection, or certain transmissible agents according to the current transmission risk assessment. In DCD: patients in whom…

…pre existing symptoms to the medication. No single diagnostic test can distinguish a pharmacological SAMS effect from a nocebo response. Predisposing factors The likelihood of…

…inflammatory cytokines that may cause plaque rupture (i.e the risk of atherosclerotic plaque rupture is increased during infections). As noted by Bonow et al…

…infection and organ dysfunction must therefore be managed as neutropenic sepsis even if the temperature criterion is not met. The first hour Step Action : : 1…

…Suspected subarachnoid haemorrhage with a normal or non diagnostic CT. Suspected neuroborreliosis, neurosyphilis or another CNS infection. Suspected inflammatory disease: multiple sclerosis, Guillain–Barré syndrome…

…heart disease is a complication of rheumatic fever, which is caused by streptococcal infections (group A Streptococcus ). Rheumatic heart disease can occur at any age…

…injuries, hemodynamic and respiratory instability, multiorgan failure, infections, seizures and temperature management. The ICU is the preferred level of care for the absolute majority. The…

…Cardiac tamponade is seen in Video 1 . Video 1. Cardiac tamponade. The heart is surrounded by fluid (black) and swings back and forth in the…

…used. Image by Bruce Blausen, Blausen Gallery 2014. Causes of acute pericarditis/myocarditis The most frequent cause of pericarditis is infections, in particular viral infections…

…Figure 1. ECG showing sinus tachycardia. Paper speed 25 mm/s. Calculate the heart rate by dividing 300 by the number of large boxes between…

…approximately 120 beats/min. The heart rate then increases during the first 1 to 2 months to about 150 beats/min. It then gradually decreases…

…sac) containing pericardial fluid. This fluid is produced by the mesothelian cells and consists of 25 50 mL serous fluid. Function of the pericardium The…

…the samples are sent correctly. A corticosteroid must never be injected into a joint in which infection has not been excluded. Indications Acute monoarthritis in…

…change of treatment. Common precipitants are viral infection, bacterial infection and air pollution, but often no definite trigger can be identified [1,2]. Ask specifically…

…early , preferably before or at the same time as carbohydrate administration. 3. Rapid identification of seizures, delirium tremens, infection, trauma and metabolic disturbance. 4. Monitoring…

…the direction. Disinfect and allow to air dry. 2. Anaesthetise the skin with a small amount of lidocaine without adrenaline (epinephrine). 3. Puncture 1–2…

…by contrast, is not a contraindication; the specimen may be taken even at very low platelet counts, followed by compression. Infection in the skin overlying…

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

…the eGFR stages and albuminuria. Inflammation and infection Test Reference Comment : : : CRP < 3 mg/L Rises within 6–8 h, half life about 19…

…technically correct performance is only half the task. The examination must be preceded by information about each step, take place with the patient's ongoing…

…spread of infection A small or uncooperative child Movement causes injury Preparation and equipment Otoscopy: an otoscope with a charged battery and clean disposable specula…

…a large bore cannula in a suitable vein). Standby access in a patient at risk of rapid deterioration. Intraosseous access: Cardiac arrest where venous access…

…coagulopathy or thrombocytopenia Relative Ongoing anticoagulant treatment — plan the aspiration for the trough level or pause the drug according to local practice Relative Skin infection…

…wait for complete diagnostic certainty. Sepsis is defined as life threatening organ dysfunction caused by a dysregulated host response to infection. Clinically this usually corresponds…

Procedurer A corticosteroid injection into soft tissue gives rapid but time limited pain relief and rarely alters the natural history of the disease. In lateral…

…volume is stable. 4. A maximal inspiration to total lung capacity — rapid, with a minimal pause at the top (< 1 second). 5. A maximal…

…6 hours. Infusion • Afterload reduction : Start infusion at 1 mg/hour. Increase by 0.5 mg/hour every 20 min to desired blood pressure. Maximum…

…as repeated intravenous bolus injections or as a constant dose infusion. Bolus regime : • 20 mg IV bolus over 2 minutes, followed by 20 to 80…

…causally responsible. This distinction is important because AKI after a contrast study frequently occurs in patients with several simultaneous renal insults. Infection, hypovolaemia, cardiac dysfunction…

…suspected necrotising soft tissue infection, a child who cannot tolerate the procedure while awake. Suspected necrotising fasciitis — pain that is disproportionately severe, a rapid course…

…and are given for absolute eGFR in mL/min , not eGFR relative to 1.73 m². Recalculate in patients who are markedly larger or smaller…

…10–21 mmHg). Tonometry is contraindicated with suspected perforation or infection. Removal Proceed from the least to the most invasive technique. 1. Irrigate with sterile…

…Septic phlebitis, ongoing soft tissue infection with systemic involvement. Relative: Condition Adaptation : : ABI 0.5–0.79 Reduced compression (20–30 mmHg) under vascular surgical…

…Diagnostic question Method Comment : : : Pigmented lesion, suspected melanoma Excision with a 1–3 mm margin, down into the subcutis Never a shave — the depth must…

…mean nothing. Capture is verified only when every pacing spike is followed by a wide QRS complex and a pulse that can be felt. The…

…heritable, drug associated, or associated with conditions such as systemic sclerosis, HIV infection, cirrhosis, and sickle cell disease. The classification also recognizes vasoreactivity subgroups among…

…schizoaffective disorder, HIV infection or other circumstances that may affect cessation or treatment monitoring. Single question screening can identify unhealthy drug use requiring counselling regarding…