…5 and 10 mL, artery forceps, gauze, a dressing, gloves. A cold spray or a lidocaine weal. Site Triamcinolone hexacetonide 20 mg/mL Methylprednisolone acetate…

…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…

…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…

…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…

…prednisolone < 5 mg/day Low to moderate Can usually be stopped without a prolonged taper 3 weeks, prednisolone ≥ 5 mg/day Substantial A stepwise…

…Preparation and equipment Chlorhexidine in alcohol 5 mg/mL: clean with 3–4 swabs in wide circles and let it dry for a couple of…

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

…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…

…5. If the patient tolerates the test dose without troublesome adverse effects, give a further 8 mg intravenously , slowly. Rapid injection increases the risk of…

…loosened or avulsed nail plate, or a damaged nail fold edge Nail avulsion and inspection of the nail bed, with suture of any nail bed…

…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…

…skin, smell, injection marks, medication patches and trauma. Remove contaminated clothing and wash the skin after external exposure A low Glasgow Coma Scale is not…

…to 12 mg, followed by a flush. Doses as low as 2.5 mg may terminate some tachycardias, and doses of 12 mg or less…

…Its resolution is substantially higher than that of IVUS, approximately 5–20 µm depending on the system, compared with roughly 70–200 µm for gray…

…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 …

…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…

…Infections are difficult to heal because the heart valves are not vascularized and therefore it is difficult for the immune system to reach the bacteria…

…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…

…less bleeding Mepivacaine 10 mg/mL Rapid Somewhat longer than lidocaine A common alternative Bupivacaine 2.5 mg/mL Slow Long When prolonged analgesia is…

…NIV is being considered. 4. Give short acting bronchodilators. 5. Give a systemic corticosteroid if the exacerbation is more than mild. 6. Assess the indication…

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

…Sterile preparation with chlorhexidine in alcohol 5 mg/mL, sterile drape, sterile gloves, mask and cap. Lidocaine 10 mg/mL for local anaesthesia in the…

…sterile gauze. Local anaesthetic: lidocaine 10 mg/mL, usually 5–10 mL, with a longer needle so that the periosteum can be infiltrated generously — it…

…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…

…acute dyspnoea) A normal value effectively excludes heart failure D dimer < 0.5 mg/L FEU Age adjusted threshold: age × 0.01 above 50…

…work of breathing with impending exhaustion. Threatened airway obstruction: inhalation injury, anaphylaxis, deep neck infection, an expanding haematoma, facial trauma. An anticipated course requiring a…

…Sampling for a suspected sexually transmitted infection — although chlamydia and gonorrhoea can be tested on urine or a self taken vaginal sample without a speculum…

…Suspected subarachnoid haemorrhage with a normal or non diagnostic CT. Suspected neuroborreliosis, neurosyphilis or another CNS infection. Suspected inflammatory disease: multiple sclerosis, Guillain–Barré syndrome…

…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…

…reaches the patient. Preparation and equipment Cannulae in several sizes, a tourniquet, chlorhexidine in alcohol 5 mg/mL, gauze, a transparent dressing, an extension set…

…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…

…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…

…aortic aneurysm 6 cm Relative — avoid forced manoeuvres An ongoing respiratory infection with a risk of transmission Until symptom free Haemoptysis of unclear cause Until…

…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…

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

…in increased levels of circulating pro inflammatory cytokines that may cause plaque rupture (i.e the risk of atherosclerotic plaque rupture is increased during infections)…

…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…

…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…

…abscess, a markedly unwell patient with fever and systemic upset, suspected necrotising soft tissue infection, a child who cannot tolerate the procedure while awake. Suspected…

…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…

…0.5 g twice daily 0.25 g twice daily Ciprofloxacin 400 mg twice daily 400 mg twice daily 400 mg twice daily 400 mg…

…individual assessment; certain tumour types are not a bar). Untreated generalised infection, or certain transmissible agents according to the current transmission risk assessment. In DCD…

…IV plus 1.5 g for the first dose, then 1 g × 1 IV Clostridioides difficile, primary infection, low risk of recurrence vancomycin 125 mg ×…

…an orbital floor fracture. 4. Topical anaesthesia into the lower fornix. 5. Evert the upper eyelid. Ask the patient to look down. Grasp the eyelashes…

…failure The insulin requirement falls . Reduce the dose and measure more frequently Acute illness and infection The insulin requirement rises, often despite a reduced food…

…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…

…own laboratory uses before applying it. The D dimer is raised in pregnancy, malignancy, infection, surgery, trauma and old age. A positive value is not…

…or an iodine solution. Lidocaine 10 mg/mL with adrenaline 5 µg/mL (adrenaline gives a bloodless field and a longer duration; it is safe…

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

…4: Chronic thromboembolic pulmonary hypertension (CTEPH) and chronic thromboembolic pulmonary disease Group 5: PH with unclear or multifactorial mechanisms PAH is a distinct and uncommon…

…Clinical presentation and assessment Identifying tobacco exposure Every cardiovascular assessment should establish: Current smoking status. Cigarettes smoked per day. Duration of smoking and cumulative exposure…

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

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…

…in which the patient reaches hospital early. The benefit of both methods falls steeply with the time since ingestion, and both can harm the patient…

…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)…

…A markedly raised GGT with the other tests normal is most often enzyme induction by alcohol or drugs and is often of no clinical significance…

…4745 patients within 30 days of myocardial infarction. Participants received colchicine 0.5 mg once daily or placebo. The primary composite outcome included cardiovascular death…

…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…