…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…

…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:…

…and equipment Chlorhexidine in alcohol or an iodine solution. Lidocaine 10 mg/mL without adrenaline for the block (adrenaline is safe in fingers and toes…

…than lidocaine A common alternative Bupivacaine 2.5 mg/mL Slow Long When prolonged analgesia is wanted The maximum dose of lidocaine is given in…

…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…

…medication list. Chlorhexidine in alcohol, sterile gloves, fenestrated drape, sterile gauze. Local anaesthetic: lidocaine 10 mg/mL, usually 5–10 mL, with a longer needle…

…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…

…too soft to pass through the skin on its own. Local anaesthesia: lidocaine 10 mg/mL, a millilitre or two intracutaneously and along the needle…

…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…

…mask, fenestrated drape. Chlorhexidine in alcohol 5 mg/mL. Local anaesthesia: lidocaine 10 mg/mL, 10–20 mL, a 25 G needle for the skin…

…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…

…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…

…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…

…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…

…5 mg/kg, maximum 300 mg Lidocaine (alternative) 100 mg IV, a further 50 mg 1 mg/kg Magnesium 2 g (8 mmol) IV in…

…40 cm. Mark the measurement on the electrode. 5. Anaesthetise the pharynx with lidocaine spray and lubricate the electrode generously with lidocaine gel. 6. Introduce…

…injection in marked coagulopathy or thrombocytopenia (< 50 ×10⁹/L) — choose the subcutaneous route if possible, otherwise give IM with a fine needle and 5…

…be left unprotected for the test to be interpretable. Procedure 1. Schedule the test in the morning, preferably starting between 08:00 and 09:00…

…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…

…in each case. Equivalent doses Agent Equivalent glucocorticoid dose Mineralocorticoid effect Biological half life : : : : Hydrocortisone (cortisol) 20 mg Marked Short, 8–12 hours Prednisolone 5…

…Dose Injection IV: • 150 μg in 1 ml vial. Dilute with 10 ml of normal saline and give by slow injection over 5 10…

…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…

…turned has not finished being titrated. Expect an opioid naive adult to need 5–15 mg of morphine in total. If more than that is…

…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…

…events in observational studies. OCT OCT uses near infrared light rather than ultrasound. Its resolution is substantially higher than that of IVUS, approximately 5–20…

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

…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…

…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…

…blood gas in respiratory compromise, low saturation, suspected carbon dioxide retention, reduced consciousness, or when NIV is being considered. 4. Give short acting bronchodilators. 5…

…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…

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

…and plan B before you give the induction agent. Preparation and equipment Go through the equipment out loud with the team, not in your head…

…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

…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…

…to mean that an electronic alert replaces clinical judgement [5]. Recognising sepsis Suspected or confirmed infection together with new organ dysfunction must raise the suspicion…

…maximal inspiration to total lung capacity — rapid, with a minimal pause at the top (< 1 second). 5. A maximal forced expiration : an explosive start…

…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…

…safe in patients with coronary artery disease since it does not increase heart rate, and reduces myocardial oxygen consumption. Time to onset of action: 5…

…of COVID 19 have been elucidated in recent studies from China and Italy (1–5). Two recent studies published in JAMA Cardiology are summarized below…

…rise in serum creatinine beginning 24–48 hours after exposure, with a peak at approximately 3–5 days and resolution within about 1 week in…

…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…

…doxycycline 200 mg × 1 on day 1, then 100 mg × 1 5–7 days Epiglottitis and other severe upper airway infection cefotaxime 1–2 g…

…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…

…or surgery in the last 4 weeks 1.5 Previous deep vein thrombosis or pulmonary embolism 1.5 Haemoptysis 1 Active malignancy 1 Two level…

…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…

…5: PH with unclear or multifactorial mechanisms PAH is a distinct and uncommon form of precapillary PH. It is defined haemodynamically by precapillary PH in…

…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…

…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)…

…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 …