…1 mg/mL, an antihistamine, oxygen, and the ability to lay the patient down. Injection Needle Angle Maximum volume per site : : : : Deltoid, adult 23–25…

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

…baseline sample : cortisol and plasma ACTH. The ACTH sample is taken before the injection and handled chilled. 4. Inject 0.25 mg of tetracosactide intravenously …

…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…

…and dose Risk of HPA suppression Tapering : : : < 3 weeks, at any dose Low Can be stopped straight away 3 weeks, prednisolone < 5 mg…

…and a fenestrated drape for injection. A needle of 0.8–1.2 × 50 mm for large joints (knee, shoulder), 0.5–0.6 × 25…

…10 ml of normal saline and give by slow injection over 5 10 minutes. Dilute immediately before use. PO: Alternatives: Dixarit 25 μg tablets…

…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…

…dose without troublesome adverse effects, give a further 8 mg intravenously , slowly. Rapid injection increases the risk of nicotinic effects with paradoxically increasing weakness. 6…

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

…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…

…sequence induction is used when intubation is required [1]. In salicylate poisoning, intubation with an inadequate minute ventilation can rapidly worsen the acidaemia and increase…

…usually within 30 seconds. Doses higher than 18 mg are unlikely to revert a tachycardia and should not be used. Specific dosing adjustments are required…

…occult structural abnormality. IVUS IVUS generates images by transmitting ultrasound from an intracoronary catheter and recording echoes reflected from the vessel wall. Contemporary systems use…

…mg. Renal failure or renal replacement therapy No dosage adjustment is required in renal failure or renal replacement therapy. Pediatric patients Body weight < 50…

…50% renal elimination. • Typically the first choice of drug. • Effective in sinus bradycardia or AV node block. • Dose <0.5 mg may worsen bradycardia and…

…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…

…only signs of infection. Corticosteroids and other immunosuppressive treatments can blunt the febrile response. A neutropenic patient with a suspected infection and organ dysfunction must…

…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…

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

…consent, current full blood count and coagulation screen, medication list. Chlorhexidine in alcohol, sterile gloves, fenestrated drape, sterile gauze. Local anaesthetic: lidocaine 10 mg/mL…

…the most stable dressing, lowest risk of infection and thrombosis with prolonged dwell time Highest risk of pneumothorax, the vessel cannot be compressed after arterial…

…Electrolytes and renal function See the renal parameters for the eGFR stages and albuminuria. Inflammation and infection Test Reference Comment : : : CRP < 3 mg/L…

…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…

…neuroborreliosis, neurosyphilis or another CNS infection. Suspected inflammatory disease: multiple sclerosis, Guillain–Barré syndrome, autoimmune encephalitis. Meningeal carcinomatosis and CNS involvement in haematological malignancy. Investigation…

…exostoses Narrow and hard to reach Ongoing otitis externa Pain, spread of infection A small or uncooperative child Movement causes injury Preparation and equipment Otoscopy…

…a tourniquet, chlorhexidine in alcohol 5 mg/mL, gauze, a transparent dressing, an extension set with a three way tap, and saline for flushing. An…

…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…

…parallel and must not wait for complete diagnostic certainty. Sepsis is defined as life threatening organ dysfunction caused by a dysregulated host response to infection…

…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…

…infusion rate 25 mg/hour. Adverse effects Tachycardia. Flushing. Headache. Angina pectoris. Caution Heart failure. Angina pectoris (ischemic heart disease). Hydralazine doses and administration in…

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

…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…

…anaesthetic. Place a field block in healthy skin around the abscess instead of injecting into it, and expect the procedure to hurt even so. Offer…

…in properly selected patients. Tenecteplase 0.25 mg/kg is a safe and effective alternative to alteplase and is simpler to administer, since the whole…

…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…

…stabilisation or piperacillin–tazobactam 4 g × 4 IV plus gentamicin 5–7 mg/kg IV as a single dose Urosepsis with shock and suspected ESBL…

…magnifying loupe and a Wood's lamp. Oxybuprocaine or tetracaine drops (topical anaesthesia). Fluorescein strips. Sterile cotton buds. An eye spud or a 25–27…

…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…

…adjusted D dimer in patients over 50: the threshold becomes age × 10 micrograms/L (FEU). Check which unit and which reference system your own laboratory…

…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…

…0.5 mg can paradoxically worsen the bradycardia and must be avoided. Atropine acts on the sinus node and the AV node and is therefore…

…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…

…Acute infection Renal or hepatic impairment Hypothyroidism Vitamin D deficiency Concomitant interacting medications The SLCO1B1 rs4149056 polymorphism is associated with higher statin concentrations and may…

…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…

…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…

…ALT 50 × the upper limit of normal: paracetamol poisoning, ischaemic hepatitis ("shock liver") or acute viral hepatitis. The three are distinguished by the history and…

…syndromes and recent myocardial infarction COLCOT The COLCOT trial enrolled 4745 patients within 30 days of myocardial infarction. Participants received colchicine 0.5 mg once…

…by streptococcal infections (group A Streptococcus ). Rheumatic heart disease can occur at any age and multiple valve lesions are common (typically the aortic and mitral…