…practice and the guidelines of the Swedish Society of Anaesthesiology and Intensive Care Medicine (SFAI), together with the antidotes. Material for immobilisation: a shoulder sling…

…nose, ears and penis has been abandoned in the modern literature for commercial preparations at normal concentrations; be cautious nonetheless in known peripheral vascular disease…

…materials: two layer system, four layer system, short stretch bandage, zinc paste bandage (Unna boot), or a class 2–3 compression stocking. Tape measure for…

…As always, foreign materials pose a high risk of infection. Approximately 20% of all endocarditis affect people with valve prostheses and among other cases 18…

…activity (PEA). Evaluation and Physical Examination The source material does not provide specific details regarding the physical examination maneuvers for patients with bradycardia. Diagnostics Electrocardiography…

…infarction Definition and Pathophysiological Basis High sensitivity cardiac troponin (hs cTn) assays detect circulating troponin released from injured cardiomyocytes at substantially lower concentrations than earlier…

…lead ECG. Assessment for haemodynamic instability, acute severe heart failure and cardiogenic shock. Identification of life threatening arrhythmias. Assessment for high risk mechanical complications. Determination…

…An ultrasound machine with a high frequency linear probe, a sterile probe cover and sterile gel. Chlorhexidine in alcohol 5 mg/mL for skin disinfection…

…STEMI). The traditional term “vulnerable plaque” describes an atherosclerotic lesion thought to be susceptible to disruption and thrombosis. Typical features include a lipid rich core…

…3] . Plaque Erosion: Responsible for up to 30% of ACS cases, plaque erosion is increasingly recognized in the modern era of high intensity statin therapy…

…pattern in every case; it may represent the posterior component of a broader infarct territory. Clinical Presentation and Symptoms The source material addresses posterior infarction…

Critical care Myocardial ischemia and infarction Definition and Pathophysiology Cardiogenic shock is a state of inadequate tissue and end organ perfusion caused by cardiac insufficiency…

…detected for the first time during its management, or arise during the course of treatment. Even transient, self terminating AF during ST elevation myocardial infarction…

…the specific context of perioperative care in patients with pulmonary arterial hypertension (PAH), progression of right heart failure may indicate the need for inodilator therapy…

…130/80 mmHg on more than two measurements obtained at separate times, whereas European recommendations for initial combination therapy refer principally to confirmed blood pressure…

…Take care in impaired sensation (neuropathy, spinal cord injury) — the patient does not feel the pressure sore. Preparation and equipment Material Comment : : Stockinette Innermost against…

…does not use the terms “controlled resistant hypertension” for blood pressure at target on four or more drugs or “refractory hypertension” for blood pressure above…

…patient should remain seated comfortably in a quiet environment for 5 minutes. The back and arm should be supported, with the cuff at heart level…

…request form. Drainage material: rubber dam drain, a strip cut from a glove, petrolatum impregnated packing strip or a vessel loop for loop drainage. Gauze…

…and the potential for stroke even at blood pressure levels that might otherwise be considered only moderately elevated. The syndrome can produce widespread maternal complications…

…pads should be positioned as standard, and defibrillation energy levels should remain consistent with those used for non pregnant adults. The fetus is not harmed…

…Aspirate and biopsy answer different questions and do not replace one another: the aspirate shows cellular morphology and provides material for flow cytometry and genetics…

…coexistence of defined clinical and laboratory components; the diagnostic criteria themselves are not reproduced in the available source material. Waist circumference is particularly important because…

…Definition and pathophysiology A chronic total occlusion (CTO) is a complete or nearly complete coronary arterial obstruction that has persisted for at least 30 days…

…principal drugs identified in the source material are canagliflozin, dapagliflozin and empagliflozin; sotagliflozin is a related dual SGLT1/SGLT2 inhibitor. SGLT2 is a high capacity…

…insect in the ear canal. A 30–60 mL syringe with a soft catheter and body temperature water for irrigation. Small children need help to…

…The terminology is hard to follow without a picture, and several of the steps below refer to structures that are not visible when looking at…

…and Symptoms The source material does not provide specific information on the clinical presentation and symptoms of the underlying conditions for which ACE inhibitors are…

…injury Long term heavy consumption can produce a cardiomyopathy, although the exact exposure threshold and duration required are not established. The source material identifies chronic…

…effect according to sex. P2Y12 inhibitor monotherapy A P2Y12 inhibitor may be used instead of aspirin for long term secondary prevention, particularly when aspirin is…

…hypothermia, and hyperkalemia. For recurrent symptomatic bradycardia, temporary or permanent pacing may be required. However, transcutaneous pacing in the setting of cardiac arrest has not…

…In this setting, the risk of sudden death and end stage heart failure is high, and assessment for advanced therapies may be required. Evaluation and…

…High bleeding risk (HBR) should be assessed in a structured manner. Within the ARC HBR framework, HBR is defined by the presence of at least…

…a large randomized trial involving 7447 individuals at high cardiovascular risk reported a 30% reduction in major cardiovascular events with a Mediterranean diet supplemented with…

…counteracted elastic recoil, reduced emergency vessel closure and decreased the need for emergency CABG. Metal only stents, now termed BMS, reduced restenosis compared with balloon…

…level C. The European regulatory threshold described in the source material differs from the trial based threshold: ivabradine was approved for patients with HFrEF, LVEF…

…of thrombotic or atheroembolic material, but pharmacological and mechanical strategies directed specifically at reperfusion injury have not generally demonstrated sufficient clinical benefit for routine use…

…source material does not provide a detailed description of the presenting symptoms of NSTEMI. It does identify several clinical manifestations that indicate particularly high risk…

…patient’s clinical context and the results of all relevant investigations. Haemodynamic definition At rest, PH is defined invasively by a mean pulmonary arterial pressure…

…material does not cover the baseline clinical presentation and symptoms of the arrhythmias for which sotalol is prescribed. Evaluation and Physical Examination The source material…

…be clinically occult and can affect multiple vascular territories, including the renal, carotid, vertebral and coronary arteries. In one study cited in the source material…

…autopsy documents thrombosis and the diagnostic criteria used for type 1 myocardial infarction are fulfilled. The temporal relationship to stent implantation should always be specified…

…enough. Lidocaine 10 mg/mL to anaesthetise the marrow cavity in a conscious patient. Fixation material for the intraosseous needle. Procedure Peripheral venous cannula 1…

…the radiology department The thresholds for the INR and the platelet count vary between regions. Common practice is correction at an INR above 1.5…

…substitute for mobilisation and bladder training. Contraindications Type Condition : : Absolute Suspected urethral injury — blood at the meatus, a perineal or scrotal haematoma, a high riding…

…The source material does not provide a detailed standardized physical examination protocol beyond assessment for a pulsatile abdominal mass and associated manifestations. Screening for AAA…

…of at least 70% is low, reported as 0–3.1%. In contrast, within selected high risk populations, prevalence may be sufficiently high for targeted…

…The preferred terminology is contrast associated AKI when temporal association is present; contrast induced AKI should be reserved for the smaller subgroup in which iodinated…

…described for high risk patients with atherosclerotic peripheral arterial disease. Chronic coronary syndrome Patients with chronic coronary syndrome are considered to be at very high…

…depend on the vascular territory involved and may include manifestations of coronary, cerebral or peripheral arterial disease, although the source material does not specify symptom…

…search for secondary contributors is an essential first step. Recognised causes include: Diabetes and insulin resistance Thyroid disease Kidney disease Excessive alcohol consumption Diets high…

…in the source material. Clinical Presentation and Symptoms Aortic dissection is an uncommon cause of acute chest pain but carries a particularly high mortality when…

…coronary pressure assessment is recommended in patients with a very high clinical likelihood of obstructive CAD, defined in the source material as greater than 85%…

…haemodynamic compromise and rhythm disturbance. The source material does not provide a specific examination profile or diagnostic physical signs for LMCAD. Diagnostic Assessment Coronary angiography…

…presentation depends on the vascular territory involved and may include systemic arterial embolic manifestations. The source material does not provide a detailed catalogue of specific…

…troponin rise, with thresholds differing for PCI and CABG; and At least one additional indicator of new myocardial ischemia or procedural coronary compromise. When preprocedural…

…or high risk clinical presentation: invasive coronary angiography may be appropriate, particularly when symptoms are severe, refractory to guideline directed medical therapy, occur at a…

…apparent, and pseudo resistant hypertension The term resistant hypertension should be reserved for patients in whom the diagnosis has been carefully confirmed. Apparent resistant hypertension…

…inferior left ventricular infarction. At least minor right ventricular necrosis is found in approximately one third of patients with inferior infarction. Extensive involvement is less…

…necrosis advances from the subendocardium towards the subepicardium over several hours. The extent and tempo of injury are influenced by collateral flow, myocardial oxygen consumption…