…15–50 % < 15 % indicates iron deficiency whatever the ferritin Vitamin B12 150–650 pmol/L Grey zone 150–250: add homocysteine or methylmalonic acid…

…longer corticosteroid treatment Risk Action : : Osteoporosis Calcium and vitamin D. A bisphosphonate with longer treatment and risk factors, according to the guideline Hyperglycaemia Glucose measurement…

…a personal or family history of muscle disorders Acute infection Renal or hepatic impairment Hypothyroidism Vitamin D deficiency Concomitant interacting medications The SLCO1B1 rs4149056 polymorphism…

…leethanol Heavy metals Chelating substances Ionizing radiation Potassium iodide Iron Deferoxamine Isoniazid Pyridoxine (Vitamin B6) Methanol Fomepizoleethanol Methemoglobin forming substances Methylene blue Methotrexate Leucovorin (folinic…

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

…patellar tendon — do not inject into or beside them. Anticoagulant treatment is not a contraindication to these superficial injections. Preparation and equipment Chlorhexidine in alcohol…

…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…

…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…

…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…

…Catapress 150 μg tablets. Dose: 75 μg daily increased as required to up to 900 μg/day. Transdermal (one patch lasts for…

…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…

…6. Assess the chosen finding continuously during the window of effect, 40 seconds to 5–10 minutes after the injection . 7. Stop the test in…

…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…

…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 …

…1, 2 & 3) Evaluation of patients with suspected AV blocks requires a thorough medical history (with emphasis on causes of AV blocks; please refer to…

…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…

…change of treatment. Common precipitants are viral infection, bacterial infection and air pollution, but often no definite trigger can be identified [1,2]. Ask specifically…

…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 hub: lower the angle to close to the plane of the skin and advance a further 1–2 mm so that the catheter tip…

…suspected granulomatous disease with marrow involvement. Work up of unexplained iron, B12 or folate deficiency when blood tests are insufficient. Contraindications Severe coagulopathy or ongoing…

…technique is designed to make sure that never happens, and to make sure the catheter does not become the patient's next focus of infection…

…of 3 or more indicates a difficult intubation — call for help and get out the videolaryngoscope and plan B before you give the induction agent…

…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…

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

…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…

…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…

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

…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…

…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…

…mg × 1 5–7 days Epiglottitis and other severe upper airway infection cefotaxime 1–2 g × 3 IV Depends on the diagnosis Always assess the…

…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…

Procedurer Transcutaneous pacing takes seconds to start and can keep a patient alive until a transvenous lead is in place — but only if it is…

…PAWP is used to distinguish pulmonary venous hypertension caused by left heart disease from pulmonary vascular disease. Although a PAWP of 12 mmHg represents the…

…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…

…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…

…deterioration. The procedure itself is straightforward: ultrasound to find the fluid, an insertion site in the left lower quadrant lateral to the rectus sheath, 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)…

…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…