…injection in marked coagulopathy or thrombocytopenia (< 50 ×10⁹/L) — choose the subcutaneous route if possible, otherwise give IM with a fine needle and 5…

…contraindication to these superficial injections. Preparation and equipment Chlorhexidine in alcohol, an iodine solution or isopropyl alcohol. A depot glucocorticoid: triamcinolone hexacetonide (Lederspan 20 mg…

…0.25 mg/mL, one ampoule. A peripheral venous cannula and a saline flush. A tube for serum or plasma cortisol according to local instructions…

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

…selective intracoronary contrast injection under fluoroscopy. The procedure is performed by advancing guidewires and diagnostic catheters from a percutaneous arterial access site to the aortic…

…s sick day rules) Vomiting or diarrhoea, unable to keep tablets down Parenteral hydrocortisone. The patient must have an emergency injection at home Acute illness…

…diagnostic work up. Haemarthrosis after trauma. A symptomatic effusion causing pain or restricted movement (therapeutic aspiration). Intra articular corticosteroid injection in verified inflammatory or osteoarthritis…

…daily increased as required to up to 900 μg/day. Transdermal (one patch lasts for a week): • Catapress TTS 1 (0.1 mg/24hrs)…

…ventricle. Studies from the US and Japan has estimated that up to 2% of patients referred to PCI with a suspicion of STE ACS/STEMI…

…effect, 40 seconds to 5–10 minutes after the injection . 7. Stop the test in the event of bradycardia, bronchospasm, marked salivation or increasing weakness…

…in alcohol or an iodine solution. Lidocaine 10 mg/mL without adrenaline for the block (adrenaline is safe in fingers and toes according to modern…

…list. Always dilute morphine 10 mg/mL to 1 mg/mL (1 mL made up to 10 mL with sodium chloride) before intravenous titration. Half…

…recommended for neurological, respiratory or haemodynamic failure that cannot be corrected quickly. Rapid sequence induction is used when intubation is required [1]. In salicylate poisoning…

…6 to 12 mg, followed by a flush. Doses as low as 2.5 mg may terminate some tachycardias, and doses of 12 mg or…

…Radiofrequency or virtual histology IVUS can provide additional information regarding calcific, fibrotic, fibro fatty, and necrotic components. Virtual histology IVUS has also been used to…

…in renal failure or renal replacement therapy. Pediatric patients Body weight < 50 kg: Initial dose: 0.05 to 0.1 mg/kg Second dose…

…200 mg slow iv injection. Rarely used. Glucagon Counteracts beta blockers. An antidote to beta blockers. 2–10 mg bolus followed by 2–5 mg…

…made up of the foci of infection. Vegetations can be found on the flaps and appear as moving masses. Mural vegetations are attached to the…

…a blood gas, coagulation tests and other investigations according to the clinical picture 5 Take cultures or molecular tests from the suspected focus, but avoid…

…usually visible on plain films. Irrigation fluid: a copious volume of drinking quality tap water or sodium chloride 9 mg/mL. The volume matters more…

…reduced consciousness, or when NIV is being considered. 4. Give short acting bronchodilators. 5. Give a systemic corticosteroid if the exacerbation is more than mild…

…marked autonomic hyperactivity Up to 5 to 7 days, sometimes longer Persisting withdrawal, particularly after previous severe episodes, with concurrent physical illness or after prolonged…

…as part of fluid management. Contraindications Infection, burn or trauma over the insertion site. Insufficient collateral circulation to the hand. Vascular disease in the limb…

…Procedure 1. Place the patient in the lateral position with the knees drawn up , or prone with a pillow under the pelvis. The lateral position…

…probe cover and sterile gel. Chlorhexidine in alcohol 5 mg/mL for skin disinfection. Allow it to air dry completely before puncture. Maximal barrier precautions:…

…acute dyspnoea) A normal value effectively excludes heart failure D dimer < 0.5 mg/L FEU Age adjusted threshold: age × 0.01 above 50…

…calibrated. Working venous access, fluid and a vasopressor drawn up — push dose noradrenaline or phenylephrine must be ready before induction , not looked for afterwards. Monitoring…

…cancer screening according to the national programme. Checking an intrauterine device or a pessary. Assessment of prolapse. Sampling for a suspected sexually transmitted infection — although…

…immunosuppression, papilloedema or new focal neurological signs — CT is performed first. Preparation and equipment Informed consent, coagulation status and an up to date medication list…

…healing Ear canal stenosis or exostoses Narrow and hard to reach Ongoing otitis externa Pain, spread of infection A small or uncooperative child Movement causes…

…the old hole. Infection or burns over the puncture site. Osteogenesis imperfecta and severe osteoporosis (relative). An inability to identify the landmarks. Choice of vein…

…the aspiration for the trough level or pause the drug according to local practice Relative Skin infection, herpes zoster or burns over the puncture site…

…results must not be taken to mean that an electronic alert replaces clinical judgement [5]. Recognising sepsis Suspected or confirmed infection together with new organ…

…occupational exposure to dust, gas or fumes. Preoperative assessment before thoracic or upper abdominal surgery in a patient with known lung disease. Follow up of…

…Time to onset of action 10 30 minutes. Duration of action <4 hours. Delivery IV or IM. Dose Injections • IV: 10–40 mg every 4…

…2 to 4 hours Delivery IV Dose Can be given as repeated intravenous bolus injections or as a constant dose infusion. Bolus regime : • 20 mg…

…of atherosclerotic plaque rupture is increased during infections). As noted by Bonow et al, it is also reasonable to believe that patients with heart failure…

…with an eGFR of 30–44 mL/min/1.73 m2 and up to 17% when eGFR is below 30 mL/min/1.73 m2…

…non HDL C by up to approximately 50% and apolipoprotein B by approximately 20–40%. Effects on triglycerides and lipoprotein(a) are variable or modest…

…abscess instead of injecting into it, and expect the procedure to hurt even so. Offer nitrous oxide, oral or intravenous analgesia, or procedural sedation in…

…10. In unknown time of onset, wake up stroke or a late time window: perform advanced imaging according to the local protocol. 11. Document weight…

…in mL/min , not eGFR relative to 1.73 m². Recalculate in patients who are markedly larger or smaller than average. Higher doses may be…

…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…

…5–7 days or doxycycline 200 mg × 1 on day 1, then 100 mg × 1 5–7 days Epiglottitis and other severe upper airway infection…

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

…or repeated doses, according to the local protocol Renal failure The insulin requirement falls . Reduce the dose and measure more frequently Acute illness and infection…

…the presence of clinical signs of infection — all chronic wounds are colonised, and a culture taken without clinical suspicion leads only to unnecessary antibiotics. 5…

…contraindication. The agent and dose are according to the local protocol. Alternatives when there is a contraindication: catheter directed treatment or surgical embolectomy where available…

…rarely needs to be stopped for small biopsies, but have diathermy or aluminium chloride available. Infection in the area to be biopsied. Hypersensitivity to local…

…of 0.5–1 mg intravenously, repeated every three to five minutes to a total maximum of 3 mg . Doses below 0.5 mg can…

…PH due to chronic lung disease, hypoxia, or sleep disordered breathing Group 4: Chronic thromboembolic pulmonary hypertension (CTEPH) and chronic thromboembolic pulmonary disease Group 5:…

…Exposure to second hand smoke. Use of cannabis, electronic cigarettes or other inhaled products. Readiness to attempt cessation. Depression, schizophrenia, schizoaffective disorder, HIV infection or…

…index Asian ancestry Previous muscle disease or a personal or family history of muscle disorders Acute infection Renal or hepatic impairment Hypothyroidism Vitamin D deficiency…

…cyanosis or marked breathlessness — withdraw the tube to the pharynx and start again . If the tube emerges through the mouth it has coiled up in…

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

…over the insertion site Change the puncture site Preparation and equipment Ultrasound with a curved array probe. Sterile preparation (chlorhexidine in alcohol 5 mg/mL…

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

…the suspicion to bone, pregnancy or malignancy. A markedly raised GGT with the other tests normal is most often enzyme induction by alcohol or drugs…

…4745 patients within 30 days of myocardial infarction. Participants received colchicine 0.5 mg once daily or placebo. The primary composite outcome included cardiovascular death…

…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…