…1 mg/mL, an antihistamine, oxygen, and the ability to lay the patient down. Injection Needle Angle Maximum volume per site : : : : Deltoid, adult 23–25…

…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…

…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…

…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…

…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…

…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…

…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…

…accessory respiratory muscles or paradoxical abdominal breathing Impending muscle fatigue Respiratory rate above 25 to 30 per minute Increased risk of ventilatory failure New drowsiness…

…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…

…as part of fluid management. Contraindications Infection, burn or trauma over the insertion site. Insufficient collateral circulation to the hand. Vascular disease in the limb…

…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…

…the eGFR stages and albuminuria. Inflammation and infection Test Reference Comment : : : CRP < 3 mg/L Rises within 6–8 h, half life about 19…

…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…

…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…

…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…

…in properly selected patients. Tenecteplase 0.25 mg/kg is a safe and effective alternative to alteplase and is simpler to administer, since the whole…

…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…

…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…

…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…

…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…

…rarely needs to be stopped for small biopsies, but have diathermy or aluminium chloride available. Infection in the area to be biopsied. Hypersensitivity 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…

…precapillary pulmonary vascular component. PAWP is used to distinguish pulmonary venous hypertension caused by left heart disease from pulmonary vascular disease. Although a PAWP of…

…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…