…angina or diabetes, and consultation with relatives or physicians before contacting emergency services. These factors support the need for targeted public education, particularly among underserved…

…book was at best poor. It is outdated, oversimplifies the concepts and basically lacks everything you need for clinical purposes. Regrettably, I cannot recommend this…

…not 48. The 2024 ESC guidelines and several Swedish clinical knowledge resources have tightened the former 48 hour rule for patients with risk factors. Check…

…intensive care Intermediate–high Stable Yes Raised Admission with monitoring. Be prepared for rescue thrombolysis Intermediate–low Stable One of the two positive Admission Low…

…be targeted at that cause. With regards to medications, the clinical need must be reconsidered if bradycardia is a side effect of the medication. Often…

…needs help from another person Level 3 can occur even when the glucose has already begun to rise by the time it is measured, for…

…for health care professionals. Contact the centre early in serious, unusual or unclear poisoning, with modified release preparations, mixed poisoning, pregnancy, children, a need for…

…for example in pregnancy, acute glomerular disease or scleroderma renal crisis [1,2]. A hypertensive emergency means a markedly raised blood pressure together with ongoing…

…Exercise Intensity Intensity may be prescribed using several complementary approaches. Heart rate based methods For patients with cardiovascular disease, dynamic aerobic exercise may be prescrib

…or a need for repeated calcium treatment. Urgent investigations As a rule, take: Plasma potassium as a central laboratory sample. A blood gas with pH…

…septic shock, or a need for high dependency or intensive care 3 Take at least two sets of blood cultures from separate peripheral punctures. Also…

…Prepare airway equipment and contact anaesthesia early with a prolonged seizure, repeated doses of benzodiazepine, aspiration, hypoventilation, circulatory failure or an anticipated need for anaesthesia…

…or a need for a vasopressor After initial stabilisation Repeat the lactate if it was raised and follow the trend together with the clinical perfusion…

Procedurer For many patients a gynaecological examination is associated with a sense of exposure, and technically correct performance is only half the task. The examination…

…vasodilators replicate the effects of exercise on coronary arteries, without the need for physical activity. Advantages of regadenoson over adenosine Regadenoson has advantages over adenosine…

…was created to address the need for a standardized method to evaluate the anatomical complexity of CAD, particularly in patients with multivessel disease or left…

…resting full cycle ratio [RFR], and related resting indices) simplified the procedure by removing the need for pharmacologic hyperemia, and angiography derived indices (quantitative flow…

…medical system (EMS), as well as the hospital cardiac arrest team (CAT) and intensive care units and other units caring for resuscitated patients. Figure 1…

…enhancing consistency in patient care. Non Invasiveness: The calculation relies on readily available clinical parameters, eliminating the need for more invasive and costly direct measurements…

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

…Thromboembolic risk, for example immobilisation, cancer and previous venous thromboembolism. A documented decision on the ceiling of care. Signs of a serious condition Finding Significance…

…reference for their use in the emergency department, the intensive care or coronary care unit, and the operating theatre. Careful electrocardiographic and haemodynamic monitoring with…

…shaped associations are considered unreliable for guiding treatment because of potential confounding, reverse causality, and the association of arterial stiffness with both low DBP and…

…procedure, or over a few days at home for a hard plug. Have the patient lie with the ear uppermost for 5 minutes after instillation…

…CKD). These agents interfere with the renin angiotensin aldosterone system (RAAS) by inhibiting the enzyme responsible for the conversion of angiotensin I to angiotensin II…

…person breathe? Look for respiratory signs for 10 seconds. Palpation of pulses : carotid, femoral or radial artery. According to current guidelines, laypeople do not need…

…pacemaker allows for adequate (high) dosing of rate controlling drugs (e.g beta blockers) without the risk of worsening the bradycardia. Persons with sick sinus…

…from different angles. This means that ECG leads with similar angles must display similar ECG curves (diagrams). For some purposes (e.g. diagnosis of some…

…during intensive care. Exhausted peripheral venous access during prolonged intravenous therapy. The need for central access is not in itself an indication for emergency insertion…

…third trimester pregnancy, marked reflux. A need for high airway pressures, for example severe ARDS, marked obesity or a stiff chest wall. Glottic or subglottic…

…2. Designate a team leader and one person responsible for recording the transfusions, the sampling, the incoming products and contact with the blood bank. 3…

…volume. A need for accurate measurement of urine output in a critically ill patient. Perioperatively and postoperatively in longer procedures and with epidural anaesthesia. Bladder…

…no imaging evidence of RV dysfunction. Catastrophic or “supermassive” PE refers to refractory cardiogenic shock or the need for ongoing cardiopulmonary resuscitation. Mechanical circulatory support…

…ischaemic risk, bleeding risk, need for anticoagulation, and whether coronary stents are present. Clinical objectives of therapy The main objectives of antiplatelet treatment after MI…

…emergency vessel closure and decreased the need for emergency CABG. Metal only stents, now termed BMS, reduced restenosis compared with balloon angioplasty but did not…

…objectives DAPT is used in two principal settings: After ACS , whether managed medically or with revascularization. After elective PCI for CCS , particularly after stent implantation…

…ultimately prevailed. The need for a standardized global definition led to early efforts by the World Health Organization in the mid 20th century, relying primarily…

…this score. A high HAS BLED score (≥3) indicates a need for closer clinical monitoring and aggressive modification of reversible risk factors (e.g., treating…

…underscoring the need for a structured and guideline directed approach. This chapter focuses on practical diagnostic and therapeutic considerations, with recommendations aligned with current guidelines…

…of tendon xanthomas, corneal arcus and xanthelasma. Potential secondary causes of hypercholesterolaemia. The likelihood of a monogenic disorder and the need for family based screening

…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…

…and severity of underlying cardiovascular disease. Conduction disease and the need for pacemaker therapy may be more frequent in T2DM, although management follows the same…

…circulation is maintained for 20 consecutive minutes, without the need for chest compressions. ECMO is considered in individuals who can survive with satisfactory quality of…

…started in an opioid naive patient, or when a conversion between drugs is made without reduction for incomplete cross tolerance. Indications Acute severe nociceptive pain…

…are the same as for a central venous catheter — coagulopathy, infection at the puncture site, known thrombosis in the target vein. With a mechanical tricuspid…

…consciousness with inadequate protective reflexes active major haematemesis severe agitation respiratory failure an anticipated difficult or prolonged endoscopic intervention a need for general anaesthesia for…

…for transfer in a suspected fracture. Clinical suspicion of a scaphoid fracture despite a normal radiograph. Contraindications An open fracture or a wound that needs…

…stable enough for there to be time to ask it. Indications Wide complex tachycardia where ventricular tachycardia must be distinguished from supraventricular tachycardia with bundle…

…diabetes care in the hospital. Endocrine Society clinical practice guideline on the management of hyperglycaemia in hospitalised adults. The summary of product characteristics for each…

…and a history of anaphylaxis — a relative contraindication; the test is then performed with preparedness for anaphylaxis. An untreated Addisonian crisis in progress: treat first…

…Contraindications There are no absolute contraindications. Take care in: Anticoagulant therapy — this rarely needs to be stopped for small biopsies, but have diathermy or aluminium…

…early — within the first hour after ROSC, in parallel with coronary angiography, the search for the cause and the rest of the intensive care. 2…

…presence and absence of intrinsic cardiac activity, Modern pacemakers are packed with algorithms that optimize the function. For example, there are functions that continuously reassess…

…severe acute or chronic heart failure. Consider urgent angiography in patients with unknown etiology for acute severe heart failure. A recent echocardiographic examination should be…

…there are generally no reliable and safe drugs available for long term heart rate augmentation without undesirable side effects. Drugs, With Doses and Practical Co

…detrimental. We have therefore compiled a pocket guide with a universal interpretation algorithm. These 22 pages includes all you need to perform methodological ECG interpretation…

…organ damage. Although BP reduction is required, these patients generally do not need hospital admission or intravenous treatment. Some patients with acute pain, anxiety, or…

…Failure to rate adjust, which means that the pacemaker fails to adjust its rate according to haemodynamic needs. This is only relevant in rate responsive…

…wall motion abnormality (RWMA) during stress. A fixed abnormality that remains unchanged with stress generally indicates previous infarction. Extensive ischaemia may produce a reduction in…