…1 mg IV every 3 5 minutes, maximum 3 mg IV. T½ 3 h. 50% renal elimination. • Typically the first choice of drug. • Effective in…

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

…the skin with a small amount of lidocaine without adrenaline (epinephrine). 3. Puncture 1–2 cm proximal to the wrist crease at an angle of…

…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…

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

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

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

…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…

…illness. Confusing dexamethasone 0.75 mg with prednisolone 0.75 mg. A tenfold difference in effect. Giving the morning dose late in the day , which…

…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…

…Catapress TTS 1 (0.1 mg/24hrs). • Catapress TTS 2 (0.2 mg/24hrs) • Catapress TTS 3 (0.3 mg/24hrs) Dosage in renal failure…

…octopus trap). Refer to Figure 1 and Figure 2. Figure 1. Echocardiogram showing takotsubo cardiomyopathy in acute phase (A) and resolution phase (B). Note the…

…10 mg/mL, 1 mL (named patient product — order well in advance). Atropine 0.5 mg for premedication, plus further atropine drawn up in a…

…inspection of the nail bed, with suture of any nail bed laceration Contraindications There are no absolute contraindications, but be cautious and consider referral in…

…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…

…failure that cannot be corrected quickly. Rapid sequence induction is used when intubation is required [1]. In salicylate poisoning, intubation with an inadequate minute ventilation…

…required in certain patient populations: Pediatric patients: For patients weighing less than 50 kg, the dosing should be 0.05 to 0.3 mg/kg…

…thrombus, and implanted stents. The principal modalities used in the catheterization laboratory are intravascular ultrasound (IVUS) and optical coherence tomography (OCT). Unlike coronary angiography, which…

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

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

…infection and organ dysfunction must therefore be managed as neutropenic sepsis even if the temperature criterion is not met. The first hour Step Action : : 1…

…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…

…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…

…detoxification. Benzodiazepines reduce the severity of withdrawal and the risk of seizures and delirium [1,2]. In delirium tremens the aim should be a calm…

…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…

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

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

…uncuffed tube age/4 + 4 tube size × 3 Term newborn 3.0–3.5 6 + weight in kg Always have one size smaller to hand…

…menstrual status, previous smear results and any previous conisation. Procedure Inspection The patient lies in the lithotomy position, well covered. Say what you are do

…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…

…slight change of pressure with the bulb shows whether the tympanic membrane is mobile — an immobile membrane suggests fluid in the middle ear. Irrigation 1…

…enough. Lidocaine 10 mg/mL to anaesthetise the marrow cavity in a conscious patient. Fixation material for the intraosseous needle. Procedure Peripheral venous cannula 1…

…but never below the ninth rib . Procedure Ultrasound localisation 1. Scan in the position in which the patient is to be punctured. Identify the diaphragm…

…dysfunction caused by a dysregulated host response to infection. Clinically this usually corresponds to an acute increase in the SOFA score of at least 2…

…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…

…IM: 10–20 mg every 4–6 hours. Infusion • Afterload reduction : Start infusion at 1 mg/hour. Increase by 0.5 mg/hour every 20…

…followed by 20 to 80 mg every 10 minutes to a total dose of 300 mg. Infusion regime : • 0.5–2 mg/minute IV infusion…

…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…

…estimates include a rate of approximately 0–2% in patients with an eGFR of 30–44 mL/min/1.73 m2 and up to 17…

…inclisiran permits subcutaneous administration only twice yearly, an important practical distinction from therapies requiring monthly or biweekly injections. Inclisiran is used as an adjunct to…

…Intravenous thrombolysis within 4.5 hours improves functional outcome in properly selected patients. Tenecteplase 0.25 mg/kg is a safe and effective alternative to…

…daily 1 g three times daily 0.25 0.5 g twice daily 0.25 g twice daily Ciprofloxacin 400 mg twice daily 400 mg…

…opposition is presumed to have consented to donation. The person's wishes are established in this order: 1. The donation register held by the Swedish…

…CRB65 0–1) phenoxymethylpenicillin 1 g × 3 PO 5–7 days or benzylpenicillin 3 g × 3 IV Pneumonia, in chronic lung disease amoxicillin 750 mg…

…iCare, Tono Pen). Procedure Systematic examination 1. Visual acuity in each eye separately , with the patient's usual glasses and then through a pinhole. This…

…A low risk of hypoglycaemia; it can usually be continued Red flags and pitfalls Stopping basal insulin in type 1 diabetes. The single most dangerous…

…deep vein thrombosis in the acute phase. Septic phlebitis, ongoing soft tissue infection with systemic involvement. Relative: Condition Adaptation : : ABI 0.5–0.79 Reduced…

…dimer is raised in pregnancy, malignancy, infection, surgery, trauma and old age. A positive value is not a diagnosis. Risk grading in confirmed pulmonary embolism…

…Take care in: Anticoagulant therapy — this rarely needs to be stopped for small biopsies, but have diathermy or aluminium chloride available. Infection in the area…

…passed through the valve. The order of management in acute bradycardia Atropine is given in doses of 0.5–1 mg intravenously, repeated every three…

…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…

…other inhaled nicotine products. In cardiovascular medicine, the objective is not merely to reduce cigarette consumption but to achieve complete abstinence from tobacco and ultimately…

…Statins inhibit 3 hydroxy 3 methylglutaryl coenzyme A reductase, the rate limiting enzyme in cholesterol synthesis. Reduced hepatic cholesterol production increases hepatic LDL receptor expression…

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

…minutes the absorption can be reduced by around half. Liquid preparations: in practice within about 1 hour. Tablets and solid preparations: up to about 2…

…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…

…have high risk occupations or participate in competitive athletics. In the context of Brugada syndrome (BrS), pharmacologic challenge with sodium channel blockers (ajmaline or flecainide…

…SMA, AMA, IgG subclasses, caeruloplasmin in people under 40, alpha 1 antitrypsin, TSH and coeliac serology , together with ultrasound of the liver and biliary tract …

…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 rare in high income countries, presumably because streptococcal infections are treated very liberally. Figure 1 shows the aortic valve in PSAX (parasternal…