…L carnitine (limited evidence) Warfarin Vitamin K Fresh frozen plasma Prothrombin complex concentrate Actions in suspected poisoning and cardiac arrest Promptly contact the closest intensive…

…not function. The tests that reflect the synthetic function of the liver are the prothrombin time (INR) , the albumin and the bilirubin — and they become…

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

Procedurer A corticosteroid injection into soft tissue gives rapid but time limited pain relief and rarely alters the natural history of the disease. In lateral…

…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…

…Time to onset of action 1 to 2 minutes Duration of action 10 to 30 minutes Delivery IV Dose Bolus injection : 5 to 15 mg…

…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…

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

…surgeon under strictly sterile conditions. For corticosteroid injection there is an additional absolute contraindication: the slightest suspicion of septic arthritis. If the picture is unclear…

…of the medulla result in the blood pressure lowering effect. Effects Potent blood pressure lowering effect. Pain relief. Delivery IV, IM, PO, transdermal Dose Injection…

…Injection of contrast media into the ventricle will instead reveal that the apical portion of the left ventricle is dilated (hence the term apical ballooning…

…slowly. Rapid injection increases the risk of nicotinic effects with paradoxically increasing weakness. 6. Assess the chosen finding continuously during the window of effect, 40…

…or a damaged nail fold edge Nail avulsion and inspection of the nail bed, with suture of any nail bed laceration Contraindications There are no…

…undiluted syringe of 10 mg/mL makes small adjustments impossible. Procedure Intravenous titration in acute severe pain Practical points during titration: Give the injection slowly…

…level of consciousness, the pupils, tone, clonus and seizures. Give glucose in hypoglycaemia and a benzodiazepine for toxicological seizures E Temperature, skin, smell, injection marks…

…clinical site of action—the coronary artery perfusing the AV node—before the drug is eliminated. A flush should immediately follow the bolus injection to…

…required because blood causes strong backscatter of the light signal. Imaging is therefore typically performed during contrast injection or another method of temporary blood displacement…

…to moderate exacerbation of asthma symptoms. Adenosine should be used with caution in patients with obstructive lung disease or asthma. Irregular wide complex tachycardia (absolute…

…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…

…foreign materials pose a high risk of infection. Approximately 20% of all endocarditis affect people with valve prostheses and among other cases 18% show significant…

…infectious diseases physician early in a high risk course, in instability, with resistance problems, or with suspected fungal infection 10 Document the times of triag

…human bites, and all bites on the hand. These are as a rule left open. Facial bites can be sutured after careful debridement because of…

…in particular that exceeds the patient's normal variation and requires a change of treatment. Common precipitants are viral infection, bacterial infection and air pollution…

…of seizures, delirium tremens, infection, trauma and metabolic disturbance. 4. Monitoring at the appropriate level of care , with readiness for respiratory support. 5. Treatment of…

…aortic balloon pump. Assessment of stroke volume variation as part of fluid management. Contraindications Infection, burn or trauma over the insertion site. Insufficient collateral circulation…

…What usually ruins the examination is not the technique but the handling of the specimen — an aspirate that clots before the smears are made is…

…happens, and to make sure the catheter does not become the patient's next focus of infection. Indications Infusion of vesicant solutions: vasopressors, concentrated potassium…

Referensvärden Reference ranges are statistical: by definition they encompass 95 % of a healthy reference population, which means that one healthy value in twenty falls outside…

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

…transmitted infection — although chlamydia and gonorrhoea can be tested on urine or a self taken vaginal sample without a speculum. Routine gynaecological examination of asymptomatic…

…the threshold, but the threshold varies between regions. Infection of the skin over the puncture site. Marked haemodynamic instability — stabilise the patient first. CT before…

…spread of infection A small or uncooperative child Movement causes injury Preparation and equipment Otoscopy: an otoscope with a charged battery and clean disposable specula…

…Infection or burns over the puncture site. Osteogenesis imperfecta and severe osteoporosis (relative). An inability to identify the landmarks. Choice of vein and cannula size…

…local practice Relative Skin infection, herpes zoster or burns over the puncture site Relative Mechanical ventilation with a high PEEP (an increased risk of pneumothorax…

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

…Relative — avoid forced manoeuvres An ongoing respiratory infection with a risk of transmission Until symptom free Haemoptysis of unclear cause Until investigated Relative obstacles also…

…Time to onset of action 10 30 minutes. Duration of action <4 hours. Delivery IV or IM. Dose Injections • IV: 10–40 mg every 4…

…onset of action 5 to 10 minutes Duration of action 2 to 4 hours Delivery IV Dose Can be given as repeated intravenous bolus injections…

…during the infection. Systemic inflammation results in increased levels of circulating pro inflammatory cytokines that may cause plaque rupture (i.e the risk of atherosclerotic…

…causally responsible. This distinction is important because AKI after a contrast study frequently occurs in patients with several simultaneous renal insults. Infection, hypovolaemia, cardiac dysfunction…

…PCSK9. The prolonged intracellular effect of inclisiran permits subcutaneous administration only twice yearly, an important practical distinction from therapies requiring monthly or biweekly injections. Inclisiran…

…acidic environment inactivates the anaesthetic. Place a field block in healthy skin around the abscess instead of injecting into it, and expect the procedure to…

…done without losing time. 7. Perform urgent CT of the brain and CT angiography from the aortic arch to the vertex. 8. Contact the thrombectomy…

…eGFR of 30 40 mL/min for lower urinary tract infection. At an eGFR <30 mL/min the antibacterial effect is lost. Dosed independently of…

…to the next of kin. Active malignancy with a risk of transmission (an individual assessment; certain tumour types are not a bar). Untreated generalised infection…

…primary infection, low risk of recurrence vancomycin 125 mg × 4 PO 10 days Clostridioides difficile, high risk of recurrence fidaxomicin 200 mg × 2 PO 10…

…the visual acuity before anything else is done. The second most important is to look for signs of perforation — Seidel's sign, an irregular pupil…

…a high risk of hypoglycaemia 8–12 mmol/L The critically ill patient in intensive care According to the local protocol Avoid tight targets in…

…4. Culture only in the presence of clinical signs of infection — all chronic wounds are colonised, and a culture taken without clinical suspicion leads only…

…110/min, a systolic blood pressure < 100 mmHg and a saturation < 90 per cent. An sPESI of 0 indicates low risk. Anticoagulation A…

…chloride available. Infection in the area to be biopsied. Hypersensitivity to local anaesthetics. Areas at high risk of unsightly or hypertrophic scars: the sternum, the…

…mean nothing. Capture is verified only when every pacing spike is followed by a wide QRS complex and a pulse that can be felt. The…

Cardiology Respiratory medicine Definition and Pathophysiology Pulmonary hypertension (PH) is a heterogeneous pathophysiological disorder characterized primarily by elevation of pulmonary arterial pressure. It may arise…

…exposure Every cardiovascular assessment should establish: Current smoking status. Cigarettes smoked per day. Duration of smoking and cumulative exposure. Previous quit attempts and their duration…

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

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

…with the poison control centre. Gastric lavage is considered only after a life threatening ingestion of a highly toxic substance, where the patient arrives within…

…first. Procedure Choice of insertion site The left lower quadrant is the first choice : the abdominal wall is thinner there than on the right, and…

…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)…

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