…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…

… use sparingly Prepatellar and olecranon bursitis The bursa Exclude septic bursitis first Injection is considered when 4–6 weeks of adequate conservative treatment — modification of…

…then performed with preparedness for anaphylaxis. An untreated Addisonian crisis in progress: treat first, test later. Preparation and equipment Tetracosactide (Synacthen) 0.25 mg/mL…

…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…

…in the source material as greater than 85%, particularly when one or more of the following are present: Severe symptoms despite guideline directed antianginal treatment…

…the corticosteroid immediately. Do not wait for laboratory results. Take a serum cortisol and ACTH first only if this does not delay treatment. Plus fluid…

…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…

…daily increased as required to up to 900 μg/day. Transdermal (one patch lasts for a week): • Catapress TTS 1 (0.1 mg/24hrs…

…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…

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

…an iodine solution. Lidocaine 10 mg/mL without adrenaline for the block (adrenaline is safe in fingers and toes according to modern data, but there…

…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…

…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]…

…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…

…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…

…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…

…2 and AV block 3. The only treatment with a class I recommendation for the management of acute bradycardia is transcutaneous pacing. Pharmacological interventions (Table…

…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…

…is hypoxaemic. Oxygen is not a treatment for dyspnoea as such and must not be given uncontrolled simply because the patient feels breathless. Excessive oxygen…

…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…

…vasoactive treatment. Conditions in which blood pressure must be kept within narrow limits: aortic dissection, intracerebral haemorrhage, after cardiac arrest. Repeated blood gases, for example…

…to local instructions, plus a formalin container for the biopsy. No. 11 scalpel for the skin incision, sterile dressings, pressure dressing. Procedure 1. Place the…

…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…

…function See the renal parameters for the eGFR stages and albuminuria. Inflammation and infection Test Reference Comment : : : CRP < 3 mg/L Rises within 6…

…taken out and shaped before induction , a syringe for the cuff, a cuff manometer. A laryngeal mask of the correct size as a rescue airway…

…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…

…anticoagulant treatment or marked coagulopathy. A platelet count below 50 × 10⁹/L is often quoted as the threshold, but the threshold varies between regions. Infection…

…An only hearing ear. Relative (choose a manual technique or refer to ENT): Condition Reason : : Diabetes, immunosuppression A risk of necrotising otitis externa Anticoagulant treatment…

…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…

…coagulopathy or thrombocytopenia Relative Ongoing anticoagulant treatment — plan the aspiration for the trough level or pause the drug according to local practice Relative Skin infection…

…Investigation and treatment must therefore proceed in parallel and must not wait for complete diagnostic certainty. Sepsis is defined as life threatening organ dysfunction caused…

…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…

…at 1 mg/hour. Increase by 0.5 mg/hour every 20 min to desired blood pressure. Maximum infusion rate 5 mg/hour. • Antihypertensive treatment…

…IV Dose Can be given as repeated intravenous bolus injections or as a constant dose infusion. Bolus regime : • 20 mg IV bolus over 2 minutes…

…inflammatory cytokines that may cause plaque rupture (i.e the risk of atherosclerotic plaque rupture is increased during infections). As noted by Bonow et al…

…is below 30 mL/min/1.73 m2. In patients with relatively normal renal function, defined in the source material as eGFR above 60 mL…

…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…

…be incised — there, antibiotics are the treatment. Ultrasound shows the abscess as a hypoechoic or heterogeneous area whose contents move under pressure; cellulitis instead gives…

…mg/kg is a safe and effective alternative to alteplase and is simpler to administer, since the whole dose is given as a bolus [1…

…times daily 1 g two to three times daily Pivmecillinam Dosed independently of renal function for a single course of treatment Trimethoprim 160 mg twice…

…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…

…IV plus 1.5 g for the first dose, then 1 g × 1 IV Clostridioides difficile, primary infection, low risk of recurrence vancomycin 125 mg …

…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 :…

…a class 2–3 compression stocking. Tape measure for ankle circumference — this governs the choice of material and bandaging technique. Procedure Assessment 1. History: duration…

…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…

…A treatment resistant rash without a definite diagnosis. Choice of technique Diagnostic question Method Comment : : : Pigmented lesion, suspected melanoma Excision with a 1–3 mm…

…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…

…PAH may be idiopathic, heritable, drug associated, or associated with conditions such as systemic sclerosis, HIV infection, cirrhosis, and sickle cell disease. The classification also…

…HIV infection or other circumstances that may affect cessation or treatment monitoring. Single question screening can identify unhealthy drug use requiring counselling regarding cardiovascular effects…

…immune activity. Statin intolerance refers to adverse effects attributed to statin treatment that improve or resolve after reducing the dose or stopping therapy. It is…

…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…

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

…early satiety or respiratory compromise. Diuretic refractory or diuretic intolerant ascites, as recurrent treatment. Contraindications There are in practice no absolute contraindications; suspected spontaneous bacterial…

…such as isoproterenol and/or procainamide. EPS with isoproterenol is also recommended for risk stratification in specific populations, such as asymptomatic patients with pre excitation…

…most often enzyme induction by alcohol or drugs and is often of no clinical significance. Synthetic function and prognosis Child–Pugh Parameter 1 point 2…

…and colchicine has been studied as an additional therapy alongside standard treatment. Interleukin 1β inhibition Canakinumab reduced inflammatory biomarkers without affecting lipids or other…

…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…