…any dose of any statin. Partial intolerance: inability to tolerate the dose required to achieve the patient’s LDL C goal. Complete intolerance is uncommon…

…particularly when combined with metabolic imaging. Contribute to assessment of cardiac inflammation, infective endocarditis, and cardiac amyloidosis using appropriate radiopharmaceuticals. Functional perfusion imaging primarily identifies…

…As always, foreign materials pose a high risk of infection. Approximately 20% of all endocarditis affect people with valve prostheses and among other cases 18…

…Lathundar Key message Fever in a neutropenic patient is an emergency. Infection can progress rapidly, while the typical local signs of inflammation may be faint…

…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…

…a bloodless field and a longer duration. The old rule that adrenaline is forbidden on fingers, toes, nose, ears and penis has been abandoned in…

…in particular that exceeds the patient's normal variation and requires a change of treatment. Common precipitants are viral infection, bacterial infection and air pollution…

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

…Infection, burn or trauma over the insertion site. Insufficient collateral circulation to the hand. Vascular disease in the limb: marked peripheral arterial disease, Raynaud's…

…low platelet counts, followed by compression. Infection in the skin overlying the puncture site. Previous pelvic irradiation on the intended side (yields fibrotic, unrepresentative marrow…

…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…

…infection or gastroenteritis at home Double or triple the oral daily dose during the days of illness (the patient's sick day rules) Vomiting or…

…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…

…examination must be preceded by information about each step, take place with the patient's ongoing consent, and be able to be stopped at any…

…skin prick testing, a local anaesthetic weal, BCG Slow, local effect Contraindications Absolute: Infection, a wound, scar tissue, a tattoo or skin disease at the…

…which needle is chosen, and that the tubes go to the right place. In suspected bacterial meningitis it is the time to antibiotics that saves…

…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…

…but some laboratories do not accept marrow blood in their analysers — check locally. Contraindications Peripheral venous cannula: Infection, burns or trauma at the puncture site…

…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…

…tunnel syndrome The carpal tunnel An acceptable bridge to surgery De Quervain's tenosynovitis The first dorsal compartment A good effect Trigger finger The tendon…

…aortic aneurysm 6 cm Relative — avoid forced manoeuvres An ongoing respiratory infection with a risk of transmission Until symptom free Haemoptysis of unclear cause Until…

…recommended — alkaline urine increases the precipitation of calcium phosphate. Contraindications Hypokalaemia — must be corrected first or in parallel; otherwise the treatment is ineffective. Hypocalcaemia , symptomatic…

…influenza) and other viral respiratory infections. However, in some individuals the infection may be severe and deadly. Importantly, COVID 19 has caused an unprecedented number…

…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…

…of the natriuretic peptide A receptor. NT proBNP is an inactive cleavage product and has no direct biologic effect. BNP and NT proBNP have different…

…activity and cardiovascular benefit is curvilinear. The largest relative improvement occurs when an inactive person becomes even modestly active, while additional activity continues to confer…

…activated. Displacement of the tracheal tube. Cardiac arrest without adequate blood flow or ineffective compressions. While ETCO 2 is optimally measured in tracheal tubes, it…

…epinephrine . For anaphylaxis without cardiac arrest: Administer 0.5 mg epinephrine intramuscularly in the anterolateral thigh. If ineffective, repeat after 3 5 minutes. If intramuscular…

…using pericardiocentesis. In cases of cardiac tamponade, conventional chest compressions are ineffective. This is explained by the elevated intrapericardial pressure due to the tamponade. The…

…traumatic cardiac arrest often exhibit favorable neurological outcomes ( Rawshani et al ). Traumatic cardiac arrests typically result from mechanisms that render chest compressions ineffective. For instance…

…abscess, a markedly unwell patient with fever and systemic upset, suspected necrotising soft tissue infection, a child who cannot tolerate the procedure while awake. Suspected…

…to a normoxic patient Temperature Treat fever and look for an underlying infection Swallowing Keep the patient nil by mouth until swallowing has been assessed…

…course (no more than 7 days) may be given to selected patients with an eGFR of 30 40 mL/min for lower urinary tract infection…

…any retrieval: it begins when someone in the intensive care unit identifies a possible donor and the deceased person's own wishes are properly established…

…first in the stable patient. Sinus tachycardia and multifocal atrial tachycardia — treat the cause; cardioversion is ineffective. Known left atrial thrombus. A markedly enlarged left…

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

…the visual acuity before anything else is done. The second most important is to look for signs of perforation — Seidel's sign, an irregular pupil…

…also does not bind every poison. With the following substances charcoal is ineffective and management is instead governed by the antidote, supportive treatment or dialysis:…

…failure The insulin requirement falls . Reduce the dose and measure more frequently Acute illness and infection The insulin requirement rises, often despite a reduced food…

…ulcer Diabetic foot ulcer : : : : Site Gaiter area, above the medial malleolus Toes, heel, lateral malleolus, pressure points Beneath the metatarsal heads, toes, heel Edge Irregular…

…infection, surgery, trauma and old age. A positive value is not a diagnosis. Risk grading in confirmed pulmonary embolism Risk Haemodynamics Right ventricular strain (echo…

…mL (adrenaline gives a bloodless field and a longer duration; it is safe even on the fingers, toes, nose and ears), a 27 G needle…

…pacing: the relative contraindications are the same as for a central venous catheter — coagulopathy, infection at the puncture site, known thrombosis in the target vein…

…mechanisms may coexist, diagnosis and classification must integrate haemodynamics with the patient’s clinical context and the results of all relevant investigations. Haemodynamic definition At…

…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…

…ingestion unless the ingested substance has the propensity to form bezoars or is a sustained release formulation. Note: activated charcoal is ineffective against alcohols, lithium…

…considered in patients with a high risk of recurrence. Electrical cardioversion is generally ineffective in the treatment of atrial tachycardia. Multifocal atrial tachycardia Figure 4…

…discharge ( Stiell et al ). Right panel : The association between compression rate and survival to hospital discharge ( Idris et al ). Duval et al studied 3,643…