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

…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…

…in increased levels of circulating pro inflammatory cytokines that may cause plaque rupture (i.e the risk of atherosclerotic plaque rupture is increased during infections)…

…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…

…benzodiazepine (midazolam or diazepam) is the commonest combination; propofol is used in units with airway expertise. Procedure 1. Dry the skin and shave where necessary…

…inflammatory cells to vascular lesions. The interleukin 1β pathway, with downstream effects involving interleukin 6 and C reactive protein, has been a major therapeutic…

…Mild Moderate–severe Encephalopathy None Grade 1–2 Grade 3–4 Class A = 5–6 points, B = 7–9, C = 10–15…

…or biweekly injections. Inclisiran is used as an adjunct to dietary measures and maximally tolerated statin therapy, with or without other LDL C lowering drugs…

…LDL particles from the circulation. Statins also reduce production of apoB 100 containing lipoproteins and exert effects beyond LDL C reduction, including modulation of inflammation…

…episodes Iatrogenic events (e.g., during central venous catheter insertion) Underlying lung pathologies In cases of benign pneumothorax, positive pressure ventilation can precipitate a tension…

…the patient down. Injection Needle Angle Maximum volume per site : : : : Deltoid, adult 23–25 G, 25 mm 90° 1–2 mL Deltoid, BMI 35 or…

…pain relief is a diagnostic finding — and appears to reduce the risk of a post injection flare. Lidocaine 10 mg/mL without adrenaline is used…

…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…

…Time to onset of action 1 to 2 minutes Duration of action 10 to 30 minutes Delivery IV Dose Bolus injection : 5 to 15 mg…

…and Clinical Role Invasive coronary angiography (ICA) is a catheter based investigation that visualizes the coronary arterial tree after selective intracoronary contrast injection under fluoroscopy…

…therapy Peptic ulcer A proton pump inhibitor with concomitant NSAID use or a history of ulcer, not routinely Infection Consider Pneumocystis prophylaxis with high doses…

…Sterile gloves, sterile gauze, and a fenestrated drape for injection. A needle of 0.8–1.2 × 50 mm for large joints (knee, shoulder), 0…

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

…Injection of contrast media into the ventricle will instead reveal that the apical portion of the left ventricle is dilated (hence the term apical ballooning…

…withdrawing the cholinesterase inhibitor, under monitoring in a setting where the airway can be secured. Preparation and equipment Edrophonium 10 mg/mL, 1 mL (named…

…loosened or avulsed nail plate, or a damaged nail fold edge Nail avulsion and inspection of the nail bed, with suture of any nail bed…

…syringe of 10 mg/mL makes small adjustments impossible. Procedure Intravenous titration in acute severe pain Practical points during titration: Give the injection slowly over…

…of these highly efficient elimination pathways, adenosine has an extremely short elimination half life of 1 to 6 seconds. Most of the drug's pharmacological…

…strut coverage. OCT has limited tissue penetration, generally approximately 1–3 mm, and may not show the EEM through substantial plaque or calcium. Blood clearance…

…in the intensive care unit or coronary care unit. Adenosine injection must be administered quickly (1 2 seconds), followed immediately by a rapid saline flush …

…phosphodiesterase inhibitor. Exact mechanism is unknown. 100−200 mg slow iv injection. Rarely used. Glucagon Counteracts beta blockers. An antidote to beta blockers. 2–10…

…high risk of infection. Approximately 20% of all endocarditis affect people with valve prostheses and among other cases 18% show significant valvular disease. Table 1…

…infectious diseases physician early in a high risk course, in instability, with resistance problems, or with suspected fungal infection 10 Document the times of triag

…Duration Comment : : : : Lidocaine 10 mg/mL Rapid 1–2 hours The standard choice Lidocaine 10 mg/mL with adrenaline 5 µg/mL Rapid 2–6…

…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…

…particularly in patients with marked tolerance. The most important measures in severe or complicated withdrawal are: 1. A benzodiazepine in a sufficient and repeated dose…

…compressible vessel. Allen's test is still used in many units to assess the collateral circulation, but the test does not reliably predict ischaemic complications…

…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…

Procedurer What determines the outcome of a central venous catheter insertion is decided before the needle goes in: the choice of site, the use of…

…Target < 1.4 at very high risk HDL Women 1.3, men 1.0 mmol/L Triglycerides < 1.7 mmol/L 10 carries…

…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…

…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…

…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…

…for the intraosseous needle. Procedure Peripheral venous cannula 1. Apply the tourniquet 10–15 cm proximal to the intended puncture site, let the arm hang…

…between regions. Common practice is correction at an INR above 1.5 and a platelet count below 50 × 10⁹/L before drain insertion, while diagnostic…

…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…

…surgery 1 month Neurosurgery or an intracranial aneurysm Contact the responsible specialist An aortic aneurysm 6 cm Relative — avoid forced manoeuvres An ongoing respiratory infection…

…Dose Injections • IV: 10–40 mg every 4–6 hours • IM: 10–20 mg every 4–6 hours. Infusion • Afterload reduction : Start infusion at 1…

…bolus injections or as a constant dose infusion. Bolus regime : • 20 mg IV bolus over 2 minutes, followed by 20 to 80 mg every 10…

…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…

…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 alteplase and is simpler to administer, since the whole dose is given as a bolus [1,2]. In a meta analysis of three phase…

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

…first dose, then 1 g × 1 IV Clostridioides difficile, primary infection, low risk of recurrence vancomycin 125 mg × 4 PO 10 days Clostridioides difficile, high…

…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…

…it GLP 1 receptor agonist It can cause nausea and delayed gastric emptying. Bear this in mind before sedation and endoscopy DPP 4 inhibitor A…

…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…

…must not be used to rule it out The age adjusted D dimer in patients over 50: the threshold becomes age × 10 micrograms/L (FEU)…

…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…

…PAWP ≤15 mmHg, and PVR ≤2 Wood units may have increased pulmonary blood flow rather than pulmonary vascular disease. This state is termed unclassified PH…

…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…

Procedurer The insertion itself is rarely the difficult part — it is the confirmation of the position that determines whether the tube is safe. A misplaced…

…is considered only after a life threatening ingestion of a highly toxic substance, where the patient arrives within about 1 hour (a liquid preparation) or…

…straightforward: ultrasound to find the fluid, an insertion site in the left lower quadrant lateral to the rectus sheath, and a cell count plus albumin…

…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)…