…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…

…contraindication to these superficial injections. Preparation and equipment Chlorhexidine in alcohol, an iodine solution or isopropyl alcohol. A depot glucocorticoid: triamcinolone hexacetonide (Lederspan 20 mg…

…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…

…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…

…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…

…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…

…dose without troublesome adverse effects, give a further 8 mg intravenously , slowly. Rapid injection increases the risk of nicotinic effects with paradoxically increasing weakness. 6…

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

…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…

Akutsjukvård Lathundar Basic principle Manage the patient, not the list of poisons. Stabilisation according to ABCDE, the plasma glucose, a blood gas and an ECG…

…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…

…and recording echoes reflected from the vessel wall. Contemporary systems use frequencies ranging from approximately 20 to 60 MHz. Their principal advantage is tissue penetration…

…mg/kg. Maximum single dose: 0.3 mg/kg Body weight 50 kg: Adult dosage. Adverse effects Adverse effects typically persist <10 seconds due to…

…200 mg slow iv injection. Rarely used. Glucagon Counteracts beta blockers. An antidote to beta blockers. 2–10 mg bolus followed by 2–5 mg…

…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…

…Lathundar Key message Fever in a neutropenic patient is an emergency. Infection can progress rapidly, while the typical local signs of inflammation may be faint…

…tap water or sodium chloride 9 mg/mL. The volume matters more than the fluid; irrigate under pressure through a 20 mL syringe and a…

…and circulation. 2. Give controlled oxygen with a target of 88 to 92 percent until the risk of hypercapnia has been assessed. 3. Take an…

…48 to 96 hours Delirium tremens with disorientation, fluctuating attention, agitation or, more rarely, hypoactivity, hallucinations and marked autonomic hyperactivity Up to 5 to 7…

…20 G in an adult; a smaller size in children. A set with an integrated guidewire (Seldinger technique) helps when the vessel is difficult to…

…Suspected acute leukaemia, myelodysplastic syndrome or myeloproliferative neoplasm. Work up and staging of lymphoma and myeloma. Suspected bone marrow metastasis. Assessment of treatment response and…

…it to air dry completely before puncture. Maximal barrier precautions: cap, mask, sterile gown, sterile gloves and a large full body drape. Lidocaine 10 mg…

…Inflammation and infection Test Reference Comment : : : CRP < 3 mg/L Rises within 6–8 h, half life about 19 h ESR Women < 20…

…6 + weight in kg Always have one size smaller to hand. The cuff is inflated to 20–30 cmH₂O measured with a manometer — a higher…

…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…

…CT is performed first. Preparation and equipment Informed consent, coagulation status and an up to date medication list. A sterile fenestrated drape, chlorhexidine in alcohol…

…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…

…pressure ; gravity is not enough. Lidocaine 10 mg/mL to anaesthetise the marrow cavity in a conscious patient. Fixation material for the intraosseous needle. Procedure…

…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…

…threatening organ dysfunction caused by a dysregulated host response to infection. Clinically this usually corresponds to an acute increase in the SOFA score of at…

…capacity. Suspected asthma or COPD — diagnosis and follow up. Risk groups: current or former smokers over 40 with respiratory symptoms, and occupational exposure to dust…

…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…

…2 to 4 hours Delivery IV Dose Can be given as repeated intravenous bolus injections or as a constant dose infusion. Bolus regime : • 20 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…

…of up to 50–55% in guideline summaries. It also lowers non HDL C by up to approximately 50% and apolipoprotein B by approximately 20…

…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…

…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…

…generalised infection, or certain transmissible agents according to the current transmission risk assessment. In DCD: patients in whom death must be confirmed after a 20…

…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…

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

…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…

…ongoing soft tissue infection with systemic involvement. Relative: Condition Adaptation : : ABI 0.5–0.79 Reduced compression (20–30 mmHg) under vascular surgical supervision Diabetes…

…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…

…Haemostasis: aluminium chloride solution 20–35 %, ferric subsulfate, electrocoagulation. A pot of 4 % formalin, and for immunofluorescence Michel's medium or saline according to local…

…0.5–1 mg intravenously, repeated every three to five minutes to a total maximum of 3 mg . Doses below 0.5 mg can paradoxically…

…Haemodynamic definition At rest, PH is defined invasively by a mean pulmonary arterial pressure (mPAP) greater than 20 mmHg. The haemodynamic phenotype is then determined…

…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…

…cases up to 6 hours or more. Discuss this with the poison control centre. Gastric lavage is considered only after a life threatening ingestion of…

…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)…

…shifts the suspicion to bone, pregnancy or malignancy. A markedly raised GGT with the other tests normal is most often enzyme induction by alcohol or…

…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…

…heart disease is a complication of rheumatic fever, which is caused by streptococcal infections (group A Streptococcus ). Rheumatic heart disease can occur at any age…