…and about the symptoms of adrenal insufficiency. Prophylaxis during longer corticosteroid treatment Risk Action : : Osteoporosis Calcium and vitamin D. A bisphosphonate with longer treatment and…

…monophosphate (cAMP), which in turn reduces the L type calcium current (Ica.L) and the pacemaker current (If) in sinus node cells, accompanied by a…

…plaque or calcium. Blood clearance is required because blood causes strong backscatter of the light signal. Imaging is therefore typically performed during contrast injection or…

…infusion Antidote to beta blockers. Calcium Counteracts calcium channel blockers (CCB). Antidote to CCBs. 10 ml calcium 0.2 mmol/ml iv. Antidote to CCBs…

…men 1.0 mmol/L Triglycerides < 1.7 mmol/L 10 carries a risk of pancreatitis Cardiac markers and coagulation Test Reference Comment : : : High…

…blocker, a calcium channel blocker or digitalis, while awaiting the antidote and specific treatment. Bradyasystole during and after cardiac arrest with persisting electrical activity. Overdrive…

…adverse event rates similar to those with placebo, whereas approximately 10% of patients in registries and routine clinical practice report muscle symptoms. This discrepancy reflects…

…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…

…maximum 2 g Calcium chloride 10 mL of 100 mg/mL in hyperkalaemia, hypocalcaemia, calcium channel blocker poisoning 0.2 mL/kg Sodium bicarbonate 50…

…cardiac arrest and influence on outcome. Resuscitation 2012; 83:120611. Wang CH, Huang CH, Chang WT, et al. The effects of calcium and sodium bicarbonate…

…calcium blocker) Calcium iv High dose insulin with glucose IV Carbamates Atropine Pralidoxime chloride Cyanide hydroxocobalamin Cyanide antidote kit (includes amyl nitrate, sodium nitrite, and…

…For vaccination: adrenaline 1 mg/mL, an antihistamine, oxygen, and the ability to lay the patient down. Injection Needle Angle Maximum volume per site : : : : Deltoid…

…duration of effect. Lidocaine 10 mg/mL without adrenaline , 2–5 mL. Needles: 21–25 G, 40 mm for subacromial and trochanteric injection; 25–27…

…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…

…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…

…with a large effusion, 5–10 mL for smaller joints. Local anaesthesia of the skin and subcutis where needed, lidocaine 10 mg/mL. Sample tubes:…

…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…

…the airway can be secured. Preparation and equipment Edrophonium 10 mg/mL, 1 mL (named patient product — order well in advance). Atropine 0.5 mg…

…from the dorsal aspect, one injection medial and one lateral to the base of the phalanx, 2–3 mL on each side, with the needle…

…dosing errors arise at the dilution step, and an undiluted syringe of 10 mg/mL makes small adjustments impossible. Procedure Intravenous titration in acute severe…

…with insulin, a sulfonylurea, a beta blocker or liver failure Blood gas pH, pCO2, bicarbonate, lactate and, where needed, methaemoglobin and carboxyhaemoglobin Electrolytes Sodium, potassium,

…seconds. Case reports have indicated that the risk of high degree AV block and ventricular arrhythmias is greater in patients on digoxin or verapamil, although…

…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…

…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

…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…

…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…

…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…

…preparation with chlorhexidine in alcohol 5 mg/mL, sterile drape, sterile gloves, mask and cap. Lidocaine 10 mg/mL for local anaesthesia in the awake…

…needle (iliac crest or sternal needle with stylet) and a Jamshidi type biopsy needle. Syringes: a small 5–10 mL syringe for the first aspirate…

…mask, sterile gown, sterile gloves and a large full body drape. Lidocaine 10 mg/mL for local anaesthesia, normal saline to flush all lumens, suture…

…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…

…the skin on its own. Local anaesthesia: lidocaine 10 mg/mL, a millilitre or two intracutaneously and along the needle track, with a fine needle…

…largest speculum that will fit — it gives the most light and the best view. Irrigation: a 30–60 mL syringe with a soft irrigation catheter…

…and ultrasound makes the deep forearm veins accessible to those who are experienced. Size Colour Approximate flow Typical use : : : : 14 G Orange 250–300 mL…

…alcohol 5 mg/mL. Local anaesthesia: lidocaine 10 mg/mL, 10–20 mL, a 25 G needle for the skin weal and a 21 G…

…large bore peripheral cannulae 0 to 10 min A blood gas with lactate, two sets of blood cultures, and a culture from the likely focus…

…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…

…action 10 30 minutes. Duration of action <4 hours. Delivery IV or IM. Dose Injections • IV: 10–40 mg every 4–6 hours • IM: 10…

…myocardial oxygen consumption and myocardial contractility. Time to onset of action 5 to 10 minutes Duration of action 2 to 4 hours Delivery IV Dose…

…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…

…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…

…an important practical distinction from therapies requiring monthly or biweekly injections. Inclisiran is used as an adjunct to dietary measures and maximally tolerated statin therapy…

…Preparation and equipment No. 11 scalpel, curved haemostat, scissors, forceps, suction. Local anaesthesia: lidocaine 10 mg/mL with adrenaline (epinephrine). Syringe, 27 G and 21…

…9. Give thrombolysis as soon as haemorrhage and contraindications have been excluded. CT angiography or transport planning must not delay treatment unnecessarily. 10. In unknown…

…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…

…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…

…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…

…8. Tonometry if acute glaucoma is suspected (normal 10–21 mmHg). Tonometry is contraindicated with suspected perforation or infection. Removal Proceed from the least to…

…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…

…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…

…a pulse ≥ 110/min, a systolic blood pressure < 100 mmHg and a saturation < 90 per cent. An sPESI of 0 indicates low risk…

…Preparation and equipment Chlorhexidine in alcohol or an iodine solution. Lidocaine 10 mg/mL with adrenaline 5 µg/mL (adrenaline gives a bloodless field and…

…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…

…Measure the depth of insertion by laying the tube from the tip of the nose to the earlobe and from there to the xiphoid process…

…reaches hospital early. The benefit of both methods falls steeply with the time since ingestion, and both can harm the patient through aspiration. Contact your…

…an indwelling catheter. Lidocaine 10 mg/mL, 5–10 mL, 25 G for the skin wheal and 21 G for the deeper layers. Diagnostic tap…