…hydrocortisone. The patient must have an emergency injection at home Acute illness, trauma, surgery Parenteral hydrocortisone, at a dose according to the local protocol. Usually…

…These thresholds are also assay dependent. Follow up of known HPA suppression to determine whether replacement can be stopped. The test is not the first…

…ability to lay the patient down. Injection Needle Angle Maximum volume per site : : : : Deltoid, adult 23–25 G, 25 mm 90° 1–2 mL 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…

…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…

…selective intracoronary contrast injection under fluoroscopy. The procedure is performed by advancing guidewires and diagnostic catheters from a percutaneous arterial access site to the aortic…

…and a fluoride tube for glucose and lactate. For injection: the corticosteroid drawn up in its own syringe, so that the same needle can stay…

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

…ventricle. Studies from the US and Japan has estimated that up to 2% of patients referred to PCI with a suspicion of STE ACS/STEMI…

…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…

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

…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…

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

…transient first , second , or third degree AV nodal block lasting up to a few seconds. His Purkinje conduction is generally unaffected directly. Adenosine does not…

…information about the artery. The clinical value of these techniques rests on their ability to characterize the anatomy responsible for a stenosis, define plaque morphology…

…in the intensive care unit or coronary care unit. Adenosine injection must be administered quickly (1 2 seconds), followed immediately by a rapid saline flush …

…the management of bradycardia, please refer to Management of acute bradycardia. A summary of the treatments is provided below. Figure 1. Management of acute bradycardia…

…made up of the foci of infection. Vegetations can be found on the flaps and appear as moving masses. Mural vegetations are attached to the…

…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…

…the face and scalp — where the blood supply is good and a scar is stigmatising — up to about 24 hours is accepted in Swedish practice…

…following early: 1. Assess airway, work of breathing, level of consciousness and circulation. 2. Give controlled oxygen with a target of 88 to 92 percent…

…alcohol use disorder and planned follow up , not merely detoxification. Benzodiazepines reduce the severity of withdrawal and the risk of seizures and delirium [1,2]…

…the hand secured with tape. Greater extension makes the artery harder to palpate. Procedure Catheter over needle (direct technique) 1. Palpate the course of the…

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

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

…Free T4 12–22 pmol/L Free T3 3.1–6.8 pmol/L TSH is logarithmically related to T4 — a small change in T4…

…3 and 4 as back up, always with the light checked. Tubes in three sizes, a stylet or bougie taken out and shaped before induction …

…the most recent sample analysed for HPV. Invitations are sent up to and including the age of 70, and the last sample is in practice…

…tube if spectrophotometry is to be performed. Procedure 1. Position the patient correctly. The lateral position with the back towards you, the knees drawn up…

…Ear canal stenosis or exostoses Narrow and hard to reach Ongoing otitis externa Pain, spread of infection A small or uncooperative child Movement causes injury…

…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…

…and a culture from the likely focus 0 to 15 min Ringer's acetate for hypotension or hypoperfusion, usually 500 mL as a rapid bolus…

…1 hour Vigorous physical exertion 30 minutes A large meal 2 hours Withholding applies only to diagnostic spirometry with a reversibility test. At follow up…

…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…

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

…of atherosclerotic plaque rupture is increased during infections). As noted by Bonow et al, it is also reasonable to believe that patients with heart failure…

…with an eGFR of 30–44 mL/min/1.73 m2 and up to 17% when eGFR is below 30 mL/min/1.73 m2…

…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…

…10. In unknown time of onset, wake up stroke or a late time window: perform advanced imaging according to the local protocol. 11. Document weight…

…are taken from the Strama Stockholm recommendations 2025/2026 and are given for absolute eGFR in mL/min , not eGFR relative to 1.73 m²…

…Indirect criteria after circulatory arrest, following a five minute no touch period The circulation at retrieval Maintained up to retrieval Ceased; warm ischaemic time is…

…infection flucloxacillin 1 g × 3 7 days Cat bite within 2 days phenoxymethylpenicillin 1 g × 3 10 days Cat bite after 2 days, close to…

…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…

…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…

…above Severe pain Titrate the pressure up gradually Rheumatoid arthritis with vasculitis Individual assessment Repeat the ABI every three to six months during ongoing compression…

…unless there is an absolute contraindication. The agent and dose are according to the local protocol. Alternatives when there is a contraindication: catheter directed treatment…

…lesion hard to find again, and it is too late to wonder where the biopsy was taken when the report arrives. Procedure Punch biopsy 1…

…bradycardia Atropine is given in doses of 0.5–1 mg intravenously, repeated every three to five minutes to a total maximum of 3 mg …

…classification comprises five groups: Group 1: Pulmonary arterial hypertension Group 2: PH due to left heart disease Group 3: PH due to chronic lung disease…

…Exposure to second hand smoke. Use of cannabis, electronic cigarettes or other inhaled products. Readiness to attempt cessation. Depression, schizophrenia, schizoaffective disorder, HIV infection or…

…symptoms (SAMS). These range from diffuse myalgia with a normal CK and no functional impairment to myositis with muscle inflammation and elevated CK. Rhabdomyolysis is…

…marked breathlessness — withdraw the tube to the pharynx and start again . If the tube emerges through the mouth it has coiled up in the pharynx…

…be reduced by around half. Liquid preparations: in practice within about 1 hour. Tablets and solid preparations: up to about 2 hours. Modified release preparations…

…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)…

…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)…

…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…

…fatal infections and high cost. Low dose methotrexate did not reduce cardiovascular outcomes, and several other agents, including pexelizumab, losmapimod and darapladib, failed to demonstrate…

…elevated risk of developing aortic stenosis. The prevalence of bicuspid aortic valves is 1% to 2% in most Western populations. Individuals with bicuspid aortic valves…