…space. It can be caused by numerous local and systemic disorders. Accumulation of fluid in the pericardial space may lead to increased intrapericardial pressure, which…

…Furthermore, sudden cardiac arrests account for 50% of all years of life lost due to cardiovascular disease ( Myerburg et al ). Sudden unexpected cardiac arrest is…

…skin and eyes using saline solution (NaCl) if suspected of toxin exposure. Gastrointestinal lavage is infrequently employed due to aspiration risks and inconclusive evidence. However…

…a neutropenic patient is an emergency. Infection can progress rapidly, while the typical local signs of inflammation may be faint or absent. Take cultures immediately…

…as carbohydrate administration. 3. Rapid identification of seizures, delirium tremens, infection, trauma and metabolic disturbance. 4. Monitoring at the appropriate level of care , with readiness…

Procedurer What determines the outcome of a central venous catheter insertion is decided before the needle goes in: the choice of site, the use of…

…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…

…local effect Contraindications Absolute: Infection, a wound, scar tissue, a tattoo or skin disease at the injection site. Known hypersensitivity to the preparation. Intramuscular injection…

…to press the remaining fluid down. 5. If a corticosteroid is to be given: hold the needle still, change the syringe and inject. The injection…

…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…

…0 to 60 min Noradrenaline if the MAP remains below 65 mmHg or the hypotension is marked. Do not wait for a central venous catheter…

…A wound that has not been irrigated clean, has not been inspected to its depth, and has not been assessed for tendon and nerve injury…

…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…

…the hand secured with tape. Greater extension makes the artery harder to palpate. Procedure Catheter over needle (direct technique) 1. Palpate the course of the…

…laid out and labelled before the puncture begins . Specimen tubes: EDTA and heparin tubes according to local instructions, plus a formalin container for the biopsy…

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

…cancer screening according to the national programme. Checking an intrauterine device or a pessary. Assessment of prolapse. Sampling for a suspected sexually transmitted infection — although…

…according to the local protocol Renal failure The insulin requirement falls . Reduce the dose and measure more frequently Acute illness and infection The insulin requirement…

…advanced. An introducer for the atraumatic needle — it is too soft to pass through the skin on its own. Local anaesthesia: lidocaine 10 mg/mL…

…contraindication. The agent and dose are according to the local protocol. Alternatives when there is a contraindication: catheter directed treatment or surgical embolectomy where available…

…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…

…Management : : : Medial triangle of the face (nasal root, alae nasi, upper lip) Venous drainage towards the cavernous sinus Surgeon or ENT; often antibiotics Palm, fingers…

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

…pads would go. Transvenous pacing: the relative contraindications are the same as for a central venous catheter — coagulopathy, infection at the puncture site, known thrombosis…

…a light breakfast according to local practice. Let the patient rest lying down or sitting for at least 15 minutes. 2. Insert a venous cannula…

…control centre is the authoritative local source for the current indication, dosing, sampling and duration of treatment. International guidelines must be adapted to the antidotes…

…of local and systemic conditions may cause pericarditis. The most common causes are as follows: Rheumatoid arthritis (RA) Systemic Lupus Erythematosus (SLE) Acute myocardial infarction…

Introduction to Coronary Atherosclerosis, Plaques, Atherothrombosis Coronary atherosclerosis is a chronic, progressive, and highly dynamic inflammatory disease of the arterial wall. It is characterized by…

…to the suspected mechanism. No antianginal class has demonstrated consistent superiority for symptom relief in direct comparative studies, and combinations are frequently required. The central…

…the treated segment. The clinical implications range from asymptomatic angiographic disease to chronic coronary syndrome (CCS), acute coronary syndrome (ACS), myocardial infarction, and repeat target…

Myocardial ischemia and infarction Definition and therapeutic rationale Multivessel coronary artery disease (CAD) refers to clinically significant atherosclerotic disease affecting two or more major epicardial…

…not empty. Intraoperatively and postoperatively after major abdominal surgery, according to local practice. Enteral nutrition and drug administration when the patient cannot swallow safely, for…

Cardiology Myocardial ischemia and infarction Definition and pathophysiology Atherosclerosis is a chronic, inflammatory disease of the arterial wall in which lipid accumulation, vascular cell dysfunction…

…Local expertise and adequate echocardiographic facilities are available Risk stratification is required in established or suspected CAD The extent or location of ischaemia needs to…

…inflammation and thrombotic susceptibility are often systemic rather than confined to a single lesion. Consequently, local revascularization must be accompanied by systemic treatment aimed at…

…or catheterise, before puncture Pregnancy, previous extensive abdominal surgery Ultrasound guidance; choose a new site if in doubt Cellulitis over the insertion site Change the…

…lesion, but it may cause local coronary injury over time. Atherosclerotic disease appears more likely to develop in the arterial segment proximal to the bridge…

…Assessment of exercise capacity and symptoms in known heart disease. Risk assessment after myocardial infarction or before revascularisation. Evaluation of treatment effect in stable angina…

…with a cardiothoracic surgeon. Myocardial rupture after myocardial infarction, and traumatic haemopericardium — these require surgery; pericardiocentesis is at best a bridge to it. A small …

…cardinal symptom, chest pain can be present [5]. Distinguishing Features: Pleuritic pain suggests pulmonary infarction, and a history of pain exacerbation with inspiration, along with…

…Lathundar About this quick reference Treatment protocols differ between regions. Always follow the local protocol for exact infusion rates, electrolyte concentrations and level of care…

…The method is quick, cheap and requires no local anaesthetic — but it leaves no specimen . That makes the choice of lesion the critical point: never…

…below apply to adults unless otherwise stated, and paediatric doses are given per kilogram with the stated maximum. Always check against the local guideline and…

…consumption Estimation of oxygen consumption is central to the assessment of exercise capacity. Metabolic equivalents (METs) can be used to estimate the energy cost of…

…laboratory may differ between Swedish regions. Always follow the local PCI and thrombolysis protocol where it specifies another approved regimen. The first 10 minutes 1…

…last dose before an invasive procedure. Exact intervals according to the local protocol or the on call coagulation service. Bridging with low molecular weight heparin…

…Impaired consciousness. Synchronised cardioversion under sedation, at an energy level according to the local protocol. An anticoagulant is given as soon as possible, but must…

…tongue depressor, a vomit bowl. Local anaesthesia and vasoconstriction: lidocaine 4 % with oxymetazoline 0.5 % (or xylometazoline) on cotton pledgets. Cautery: silver nitrate sticks; electrocautery…

…bore access, or rapid central access, but do not delay transfusion or control of the bleeding in order to obtain a central venous catheter. 4…

…the initial sympathetic response can give way to hypotension, hypoxia, hypoglycaemia and circulatory failure [5]. Plasma glucose immediately Check the capillary or venous glucose i

…driver of global cardiovascular morbidity and mortality, primarily due to its association with ischemic stroke and systemic embolism. The contemporary understanding of AF has evolved…

…blood cultures to identify potential pathogens and guide antimicrobial therapy. Administer broad spectrum antibiotics in accordance with local clinical guidelines, ensuring timely initiation to optimize…

…underlying etiology is hypertension. Ischemic stroke occurs when a cerebral artery is occluded due to local atherothrombosis or occlusion due to embolization. Approximately 30% of…

…and otherwise according to local protocol Both the type and screen and the serological crossmatch have a limited period of validity — usually about five days…

…or upper gastrointestinal tract, ileus and ongoing upper gastrointestinal bleeding. Marked agitation or inability to cooperate. Copious secretions without an effective cough. Choice of method…

…provider. 5. Confirm delirium with a structured instrument , for example the 4AT or the CAM according to local protocol. 6. Look for several concurrent causes…

…A local anaesthetic with a vasoconstrictor for the nose: lidocaine 4 % with oxymetazoline 0.5 % on pledgets. Mineral oil or lidocaine to kill an insect…

Kardiologi Akutsjukvård Intensivvård Lathundar Clinical use This overview is a quick reference to the intravenous antihypertensive drugs used in a hypertensive emergency. It summarises the…

…available. Drugs for procedural sedation and analgesia according to local practice and the guidelines of the Swedish Society of Anaesthesiology and Intensive Care Medicine (SFAI)…

…fan, paracetamol, cold infusions. A ventilator, an arterial line, a central venous catheter, ECG monitoring, blood gases. Drugs for sedation, analgesia and control of shivering…