…with a local anaesthetic, and a decongestant nasal spray if the nasal passage is narrow. A 50–60 mL catheter syringe, a collection bag or…

…Diagnosis of a tension pneumothorax can be made via auscultation, where asymmetric lung sounds are noted, specifically with an absence of sounds on the affected…

…occur in over 40% of females and 30% of males due to a lack of effective reflex response to posture, venous pooling, or external stimuli…

…the patient must leave with clear information about the symptoms that should make them seek help immediately. Indications An undisplaced or reduced fracture to be…

CPR Sex : Male Age : 62 years History : Coronary bypass grafting; history of arrhythmias. Medications : beta blockers ECG 1 . Sinus rhythm interrupted by ventricular tachycardia (VT…

…interval. Several formulas exist to calculate QTc, each with its own characteristics. Bazett’s formula One of the earliest and most widely used correction methods…

CPR Each recording presents two leads recorded simultaneously. Sex : Male Age : 43 years History : None Medications : None ECG 1 . Sinus rhythm interrupted by rapid ventricular…

…haematuria with clots (a three way catheter). Instillation therapy and contrast studies of the urinary tract. Wound healing with a sacral pressure sore or extensive…

…No treatment Low No treatment High 1 Oral anticoagulation (warfarin or NOAK 1 is considered for male patients with a score of 1 or more…

…did not reveal structural cardiac abnormalities, nor coronary artery disease. Another male patient, with similar ST segment changes, experienced syncopal episodes, ventricular tachycardia (including torsades…

…90% of males aged 40 years or younger display this). Hence, the authors have confused a completely benign condition (male/female pattern) with a condition…

…made for confounders) individuals with atrial fibrillation are at five times increased risk of stroke and two times increased mortality, as compared with individuals without…

…ventricular fibrillation Below are sequential ECG recordings during a sudden cardiac arrest in a 43 year old male. Each ECG presents two leads recorded simultaneously…

…presented in the parenthesis). Values without confidence interval are simply the 98 th percentile (i.e the upper reference limit). Age <1 day 1–3…

…lower back or scrotum. Aneurysmal pain is clinically important because it may herald rupture and constitutes a medical emergency. Rupture may occur without preceding symptoms…

…refers to individuals without established atherosclerotic cardiovascular disease (ASCVD), coronary artery disease, cerebrovascular disease, or peripheral artery disease. Secondary prevention concerns patients with established vascular…

… male sex, subtle electrocardiographic abnormalities and particular genes may predict earlier disease expression. In many cardiomyopathies, women manifest disease later than men, with the timing…

…closely than HFpEF. Patients are more commonly male and younger than those with HFpEF and have a greater likelihood of coronary artery disease, which is…

…adverse cardiovascular events (MACE) and major adverse limb events (MALE), and improves walking distance. The role of PCSK9 inhibition in thoracic or abdominal aortic aneurysmal…

…Patients with significant heart disease (known or unknown) may not achieve the expected maximum heart rate and it may be hazardous to push them towards…

…current treatment target levels for patients with and without diabetes. The threshold for hypertension is currently 140 mm Hg systolic or 90 mm Hg diastolic …

…and V6. Leads without U waves are preferred. Calculate the mean QT interval for each lead and use the longest QT interval obtained. Large U…

…books will realize their shortcomings at their first encounter with an ECG in reality. Books that claim to make it "simple" can provide a quick…

…is not made on a single reading. It requires repeated measurements on at least two occasions, and preferably confirmation by home measurement or 24 hour…

…easy to trust too much. Two errors make the reading useless without anyone noticing: the transducer is at the wrong height , and the system is…

…not the skin. Aspiration needle (iliac crest or sternal needle with stylet) and a Jamshidi type biopsy needle. Syringes: a small 5–10 mL syringe…

…changed or removed once the situation has stabilised. Preparation and equipment A central line set with a triple lumen catheter, usually 7 Fr. Catheter length…

Referensvärden A child's ECG changes continuously with age: the heart rate, the electrical axis and the waveform in the newborn differ markedly from adult…

…lymphoma or granulomatous disease. A treatment resistant rash without a definite diagnosis. Choice of technique Diagnostic question Method Comment : : : Pigmented lesion, suspected melanoma Excision with…

…fact worse than no treatment at all at one year . The injection is therefore a tool to make rehabilitation possible, not an alternative to it…

…a potential interaction, and that there is a ready made plan for what happens when the INR runs away or the patient bleeds. In Sweden…

…starts with assessment of the P wave. The P wave is a small, positive and smooth wave. It is small because the atria make a…

…the IPAP against hypercapnia SpO₂ 88–92% Hypoxaemic failure without hypercapnia CPAP or high flow nasal oxygen 5–10 cmH₂O According to oxygenation requirement SpO₂…

…on a donor card, or through statements made to the next of kin. Active malignancy with a risk of transmission (an individual assessment; certain tumour…

…Mineral oil or lidocaine to kill an insect in the ear canal. A 30–60 mL syringe with a soft catheter and body temperature water…

…given without assessment, when a modified release preparation is started in an opioid naive patient, or when a conversion between drugs is made without reduction…

…and always urgent. A large pericardial effusion with symptoms despite medical treatment. Diagnostic drainage in suspected purulent pericarditis, tuberculosis or malignancy. Tamponade is a clinical…

…in septic shock, or when sepsis is judged certain or highly likely. With possible sepsis without shock, a rapid targeted assessment is made. If the…

…made. Otherwise, continue to next criteria. Assess the QRS morphology in V1, V2, V5 and V6 (see below). If the QRS morphology is compatible with…

…Aveed TESTOSTERONE UNDECANOATE TESTOSTERONE UNDECANOATE Heart Damage wp most major adverse cardiovascular events (MACE) severe ARISTADA ARIPIPRAZOLE LAUROXIL aripiprazole lauroxil Mixed wp less hypotension/ tachycardia…

…standardized method to evaluate the anatomical complexity of CAD, particularly in patients with multivessel disease or left main coronary artery disease . It integrates multiple variables…

…PCI or CABG based on their risk profile. Predicting Outcomes : It predicts 10 year mortality and 5 year major adverse cardiac events (MACE) with greater…

…the source material as at least eight drinks weekly in females or at least 15 drinks weekly in males, or binge drinking in either sex…

…Female specific or female predominant factors associated with later cardiovascular risk include: Premature menopause Premature ovarian insufficiency Hypertensive disorders of pregnancy Preeclampsia Preterm delivery Gestational…

…regimen remains the default for most patients with ACS, including those with NSTE ACS. It applies whether ACS is managed with PCI or without revascularization…

…develops during the third or fourth decade in males and approximately 10 years later in females. Untreated HoFH is associated with extensive premature and progressive…

…hypertrophy, or echocardiographic evidence of impaired filling, make the diagnosis more likely. HFpEF and HFmrEF together account for approximately half of patients with symptomatic HF…

…tools for cardiovascular risk reduction, offering profound benefits in major adverse cardiovascular events (MACE), heart failure with preserved ejection fraction (HFpEF), chronic kidney disease (CKD…

…evidence for their efficacy is limited. Ivabradine alone or combined with a beta blocker should be considered in symptomatic patients. This is a class IIa…

…require a QRS duration exceeding 140 msec in males and 130 msec in females , along with slurring or notching of the mid QRS in at…

…prevention targets people without clinical CVD who nevertheless have established risk factors or an elevated estimated risk. It combines lifestyle intervention with treatment of risk…

…sufficient to make a diagnosis or identify a few likely diagnoses. The table below shows a systematic history taking in patients presenting with chest pain…

…These are the main adjustments made to improve image quality. Adjusting image depth and zoom Examinations in each echocardiographic view are initialized by identifying an…

…using an electronic caliper, with the tips positioned at the interface between the compacted myocardium and the noncompacted myocardium (i.e trabeculae). The compacted myocardium…

…during diastole. Moreover, there are pronounced variations in flow during each phase, with rapidly accelerating flow in early systole, decelerating flow in late systole, and…

…with reduced motion and potentially fused commisures. Continuous Doppler is used to assess the stenosis. Doppler recordings are made during inspiration (velocities across the valve…

…surgeon The following locations must not be handled routinely in primary care or in the emergency department without contacting the appropriate specialty: Location Risk Management : …

…often visual, auditory or tactile hallucinations with a relatively clear level of consciousness and preserved orientation 12 to 48 hours Withdrawal seizures, usually generalised tonic…

…markedly enlarged left atrium, marked hyperthyroidism or an untreated underlying cause make recurrence all but certain and argue against elective cardioversion. Anticoagulation before cardioversion After…

…indication and with full preparedness Moderate to severe aortic stenosis without symptoms Individual assessment Hypertrophic cardiomyopathy with outflow tract obstruction Caution Tachyarrhythmia or bradyarrhythmia Rate…