…care unit. Adenosine injection must be administered quickly (1 2 seconds), followed immediately by a rapid saline flush (use a three way tap system). Compatible…

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

…not the subclavian. Thresholds for INR and platelet count before insertion differ between regions and departments — follow local protocol. Severe lung disease or a contralateral…

…for glucose when the diagnosis is based on HbA1c. Albumin affects the total calcium — use the ionised calcium or correct for albumin. Biotin supplements interfere…

…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…

…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…

…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…

…given dexamethasone. That is the practical key: the patient does not have to be left unprotected for the test to be interpretable. Procedure 1. Schedule…

…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…

…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…

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

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

…g in 1 ml vial. Dilute with 10 ml of normal saline and give by slow injection over 5 10 minutes. Dilute immediately before use…

…for a kind of octopus trap (the left ventricle takes the shape of that octopus trap). Refer to Figure 1 and Figure 2. Figure 1…

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

…without adrenaline for the block (adrenaline is safe in fingers and toes according to modern data, but there is rarely any reason to use it…

…started in an opioid naive patient, or when a conversion between drugs is made without reduction for incomplete cross tolerance. Indications Acute severe nociceptive pain…

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

…a tachycardia and should not be used. Specific dosing adjustments are required in certain patient populations: Pediatric patients: For patients weighing less than 50 kg…

…Imaging is therefore typically performed during contrast injection or another method of temporary blood displacement. OCT is particularly useful for: characterizing the surface of atheroma…

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

…criteria exist. Figure 1. Flow chart for the investigation of suspected endocarditis. Vegetations Vegetations are ecotate masses made up of the foci of infection. Vegetations…

…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…

…not been assessed for tendon and nerve injury will heal badly however neatly the suture is placed. The commonest cause of wound infection is retained…

…explanation for all acute dyspnoea in a patient with COPD. Pneumonia, heart failure, pulmonary embolism, pneumothorax and acute coronary syndrome must be actively considered [1…

…infection, trauma and metabolic disturbance. 4. Monitoring at the appropriate level of care , with readiness for respiratory support. 5. Treatment of the alcohol use disorder…

…are relative contraindications and are an argument for a superficial, compressible vessel. Allen's test is still used in many units to assess the collateral…

…vessels and abdominal organs is large. The sternum may be used for aspiration when the iliac crest is inaccessible, but biopsy must never be taken…

…light checked. Tubes in three sizes, a stylet or bougie taken out and shaped before induction , a syringe for the cuff, a cuff manometer. A…

…The Swedish clinical care programme for bacterial CNS infections states that CT must not be performed before lumbar puncture in suspected bacterial meningitis — not even…

…a few days at home for a hard plug. Have the patient lie with the ear uppermost for 5 minutes after instillation. Procedure Otoscopy 1…

…the marrow cavity in a conscious patient. Fixation material for the intraosseous needle. Procedure Peripheral venous cannula 1. Apply the tourniquet 10–15 cm proximal…

…with the arms on a table for diagnostic and therapeutic aspiration; for drain insertion the supine position is used with the arm abducted and the…

…mmol/L. This combination carries a high mortality [1,2]. Give antibiotics immediately and aim for administration within one hour in septic shock, or when…

…the arm span divided by 1.06 is used as the height. Procedure 1. Explain and demonstrate. Show for yourself what a maximal blow looks…

…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…

…Postoperative hypertension. Mechanism of action Combined beta adrenergic and alpha adrenergic blocker with rapid onset of action. Labetalol has less antihypertensive efficacy as compared with…

…cancer, etc – are the most important risk factors for poor outcomes. The vast majority of infections with COVID 19 result in mild disease, with symptoms…

…temporal association is present; contrast induced AKI should be reserved for the smaller subgroup in which iodinated contrast is considered causally responsible. This distinction is…

…analgesia, or procedural sedation in advance. Inadequate analgesia is the commonest reason for an incompletely performed drainage. Procedure 1. Locate the centre of the fluctuance…

…the local protocol MRI of the brain DWI FLAIR mismatch can be used for selection with an unknown time of onset when MRI is immediately…

…course (no more than 7 days) may be given to selected patients with an eGFR of 30 40 mL/min for lower urinary tract infection…

…in a formally unimpeachable way, and that the donor's organs are maintained physiologically for as long as the assessment takes. The task of the…

…or cefotaxime plus metronidazole 1 g × 3 IV plus 1.5 g for the first dose, then 1 g × 1 IV Clostridioides difficile, primary infection…

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

…consciousness or DKA: remove the pump and change to an infusion or injections Drugs for type 2 diabetes in inpatients Agent The acutely ill inpatient :…

…debridement 1. Cleanse with lukewarm tap water or saline; showering the leg is a good option. 2. Apply topical anaesthetic cream under occlusion for 30

…Stable No Normal Anticoagulation. Outpatient management may be considered The sPESI (simplified Pulmonary Embolism Severity Index) gives 1 point each for age 80 years, cancer…

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

…pads would go. Transvenous pacing: the relative contraindications are the same as for a central venous catheter — coagulopathy, infection at the puncture site, known thrombosis…

…threshold of ≤15 mmHg remains the recommended criterion for precapillary PH, partly because this value has been used in therapeutic studies of pulmonary arterial hypertension …

…quit attempts and their duration. Triggers for smoking and anticipated barriers to cessation. Exposure to second hand smoke. Use of cannabis, electronic cigarettes or other…

…muscle disease or a personal or family history of muscle disorders Acute infection Renal or hepatic impairment Hypothyroidism Vitamin D deficiency Concomitant interacting medications The…

…a fine, soft tube (Ch 8–12) of polyurethane or silicone for nutrition, since it causes less mucosal irritation with longer term use. A water…

…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…

…the relatively avascular linea alba, but requires an empty bladder and is rarely used in large volume ascites. Diagnostic paracentesis 1. Scan the left lower…

…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)…

…Grade 1–2 Grade 3–4 Class A = 5–6 points, B = 7–9, C = 10–15. MELD Na is used for…

…antibody directed against interleukin 1β, provided proof of concept but was not developed for routine coronary prevention because of fatal infections and high cost…

…income countries, presumably because streptococcal infections are treated very liberally. Figure 1 shows the aortic valve in PSAX (parasternal short axis view). Figure 1. The…