…of infection. Indications Infusion of vesicant solutions: vasopressors, concentrated potassium, cytotoxic drugs, parenteral nutrition. The need for several simultaneous, incompatible infusions. Haemodialysis, plasmapheresis or other…

…choice of device therapy and also suggest whether other interventions (e.g. heart failure management, evaluation for coronary artery disease, etc .) are warranted. Management of…

…known risk of bradycardia. Transvenous pacing is chosen when the need is more than brief: continuing pacing dependence, inadequate or unachievable transcutaneous capture, or when…

…Other microorganisms, generally, cause subacute endocarditis. Endocarditis can affect native (own) valves and valve prostheses. As always, foreign materials pose a high risk of infection…

…is more than mild. 6. Assess the indication for antibiotics on the basis of sputum purulence, the other cardinal symptoms and the severity of the…

…modification of loading, eccentric exercise, an NSAID, an orthosis — has not given a sufficient effect. Contraindications Absolute: Cellulitis, a skin wound or other infection over…

…and other viral respiratory infections. However, in some individuals the infection may be severe and deadly. Importantly, COVID 19 has caused an unprecedented number of…

…Figure 1. Flowchart showing the natural course of coronary artery disease and classification of acute coronary syndromes into STEMI, NSTEMI and unstable angina using ECG…

…lead ECG Numerous conditions that can be diagnosed using the 12 lead ECG require that ECG changes occur in two or more anatomically contiguous leads…

…abdominal pain or a rapid deterioration in general condition may be the only signs of infection. Corticosteroids and other immunosuppressive treatments can blunt the febrile…

…coexists with coronary artery disease (CAD), peripheral artery disease (PAD), and other manifestations of systemic atherosclerosis. The principal clinical concern is cerebral embolism or haemodynamic…

…myocardial perfusion imaging Diagnosis of coronary artery disease (CAD) : Myocardial perfusion imaging can confirm or rule out CAD in patients with symptoms suggestive of CAD…

…Alternative route : Central venous administration of adenosine is suitable in the intensive care unit or coronary care unit. Adenosine injection must be administered quickly (1…

…increases the quality of the examination, and allows for standardized comparisons of serial examinations. If pathology is discovered during the standard examination, other examinations (which…

…7 days or doxycycline 200 mg × 1 on day 1, then 100 mg × 1 5–7 days Epiglottitis and other severe upper airway infection cefotaxime…

…Use of cannabis, electronic cigarettes or other inhaled products. Readiness to attempt cessation. Depression, schizophrenia, schizoaffective disorder, HIV infection or other circumstances that may affect…

…in a coronary artery occurs (then of course, the ST segment will be elevated). T wave inversion (inverted / negative T waves) T wave inversion means…

…to 72 hours Increasing autonomic hyperactivity and risk of complicated withdrawal 48 to 96 hours Delirium tremens with disorientation, fluctuating attention, agitation or, more rarely…

…ischaemic electrocardiographic changes during rapid AF. ST segment depression or T wave inversion can occur without coronary artery disease. Proposed explanations in the source material…

…Indications Unexplained cytopenia in one or more cell lines. Suspected acute leukaemia, myelodysplastic syndrome or myeloproliferative neoplasm. Work up and staging of lymphoma and myeloma…

…acute coronary syndrome or guide percutaneous coronary intervention (PCI). ICA therefore has three principal roles: Defining the anatomical distribution and severity of epicardial coronary artery…

…disease and advanced CKD. The clinical course is often more rapidly reversible than that of other forms of acute tubular necrosis, although the complication remains…

…Other definitions of unhealthy drinking include at least two drinks daily in women or three in men, or at least four drinks for women or…

…sick sinus syndrome or high grade AV block without pacemaker protection. Asthma and other marked obstructive airways disease — relative; the risk of bronchospasm is real…

…closer monitoring — the patient cannot feel pressure injury Peripheral neuropathy of other cause As above Severe pain Titrate the pressure up gradually Rheumatoid arthritis with…

…treatment or marked coagulopathy. A platelet count below 50 × 10⁹/L is often quoted as the threshold, but the threshold varies between regions. Infection of…

…dissection or other vascular pathology CT perfusion Used with an unclear time of onset, a late time window, or when thrombectomy can start at the…

…instability or transiently toxic concentrations, adenosine requires a rapidly delivered bolus to achieve sufficiently high concentrations at its clinical site of action—the coronary artery…

…thrombus, or other acute complications; investigation of restenosis and stent thrombosis. Intravascular imaging may also clarify the mechanism of an acute coronary syndrome (ACS), particularly…

…ventricular tachycardia, which may degenerate into ventricular fibrillation at any age. Exercise, or any other activity causing adrenergic stimulation, increase the risk of syncope, ventricular…

…whole length of the abscess or at least half its diameter. Too small an incision is the commonest technical error. 4. Cut straight into the…

…disorder may manifest with any of the following symptoms: Syncope, pre syncope Ventricular tachycardia Ventricular fibrillation Cardiac arrest with or without sudden cardiac death Hence…

…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…

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

…choose the more patent one. Ask the patient about a previous nasal fracture or unilateral nasal obstruction. 2. Measure the depth of insertion by laying…

…safe triangle (Figure 1). Outside it the risk of injuring the diaphragm, liver, spleen or internal thoracic artery increases. For diagnostic aspiration the point chosen…

…should be utilized. The cannula is inserted into the 4th or 5th intercostal space along the anterior axillary line. Thoracostomy This method is generally deemed…

…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…

…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…

…larger , since a mask that is too small leaks and gives a poorer seal. Procedure Insertion of the laryngeal mask 1. Check the mask, remove…

…complex or the T wave. The whole value of the investigation lies in the ratio between the number of atrial and ventricular complexes — more atrial…

…ulnar pulse and a warm, well perfused hand carry more weight. Choice of vessel The radial artery is the first choice : superficial, easy to compress…

…Injection into an arm with a dialysis fistula. Preparation and equipment Hand disinfection; gloves where there is a risk of blood contact. An alcohol or…

…gradual inversion of the T waves. These T waves are called post ischemic T waves and they indicate that the infarction process is more or…

…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…

…plain films. Irrigation fluid: a copious volume of drinking quality tap water or sodium chloride 9 mg/mL. The volume matters more than the fluid;…

…insufficiency in pituitary disease, after pituitary surgery or radiotherapy, or with suspected suppression of the HPA axis after long term glucocorticoid treatment. A basal morning…

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

…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…

…a large change in TSH. During acute illness the TSH can be falsely low or high in the absence of thyroid disease; repeat it once…

…intrauterine device or a pessary. Assessment of prolapse. Sampling for a suspected sexually transmitted infection — although chlamydia and gonorrhoea can be tested on urine or…

…or an intracranial aneurysm Contact the responsible specialist An aortic aneurysm 6 cm Relative — avoid forced manoeuvres An ongoing respiratory infection with a risk of…

…Which of the following describes a 'Black athlete repolarization variant' considered a normal ECG finding? A: T wave inversion in leads V1 V3 in athletes…

…increase the entry of salicylate into the central nervous system. Discuss the case early with the poison control centre and with anaesthesia or intensive care…

…syringe. Punches of 2, 3, 4 and 6 mm. A size 15 scalpel, a double edged razor blade or a flexible shave blade. Artery forceps…

…as part of the diagnostic work up. Haemarthrosis after trauma. A symptomatic effusion causing pain or restricted movement (therapeutic aspiration). Intra articular corticosteroid injection in…

…but no coronary artery occlusion can be identified. Injection of contrast media into the ventricle will instead reveal that the apical portion of the left…

…healing Ear canal stenosis or exostoses Narrow and hard to reach Ongoing otitis externa Pain, spread of infection A small or uncooperative child Movement causes…

…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…

…total obliteration of affected vessels. Genetic, molecular, and acquired factors may interact in its development. PAH may be idiopathic, heritable, drug associated, or associated with…