…uncontrolled hypertension. Recent intracranial haemorrhage without a fresh assessment of benefit and risk. An inability to attend for sampling and follow up — relative, but in…

…atrial fibrillation Criteria for dose reduction according to FASS : : : Apixaban 5 mg × 2 2.5 mg × 2 if at least two of: age ≥ 80 years…

…time should be at least as long as the freeze time , usually 30–60 seconds. 8. Repeat the cycle where indicated according to the table…

…primarily due to its association with ischemic stroke and systemic embolism. The contemporary understanding of AF has evolved significantly; it is no longer viewed merely…

…stenting or other procedural intervention. The clinical importance of the finding is related to the extent of myocardium at risk. Occlusion or impaired perfusion in…

…to 1 mg/mL (1 mL made up to 10 mL with sodium chloride) before intravenous titration. Half of all opioid dosing errors arise at…

ECG Introduction to ECG interpretation 1. Which of the following ECG findings is typically considered a normal variant in asymptomatic athletes with no significant family…

…from fat and takes no account of fat distribution. Waist circumference and the waist–hip ratio predict cardiometabolic risk better, particularly at a BMI between…

…at least 6–10, plus spreader slides — laid out and labelled before the puncture begins . Specimen tubes: EDTA and heparin tubes according to local instructions…

…the bridge of the nose. The resistance at the posterior pharyngeal wall after about 10–15 cm is expected. 5. Ask the patient to flex…

…the prescription has no target — the nasal cannula stays in place for days without anyone asking why, or the patient at risk of carbon dioxide…

…rarely alters the natural history of the disease. In lateral epicondylitis the effect is in fact worse than no treatment at all at one year …

…If there is no RS complex in any chest lead (V1–V6) a diagnosis of ventricular tachycardia can be made. Otherwise, continue to next criteria…

…with acute heart failure. • Clevidipine can cause reflex tachycardia. • Contraindicated in severe aortic stenosis due to risk of hypotension. Clevidipine doses and administration in hypertension.

…Section DICT Concern Cardiac side effects Severity of cardiotoxicity Hyaluronic Acid HYALURONIC ACID HYALURONIC ACID NA no no ZYPREXA Relprevv OLANZAPINE PAMOATE Olanzapine pamoate Arrhythmia…

…due to the high risk of reflex sympathetic stimulation. Drug Hydralazine Brand names Apresoline ®, Bidil ® Mechanism of action • Induces arteriolar vasodilation. No effect…

…assessment of regional wall motion (left ventricle) TYPE OF MOTION DEFINITION WALL MOTION SCORE Normal Normal thickening (typically 30% thickening from end diastole to end…

…therapy. Goal: Achieve LDL C levels <1.4 mmol/L (55 mg/dL) to reduce cardiovascular risk. 1. Assess Prior Treatment • No prior treatment, low…

…via generation of cyclic GMP, which then activates calcium sensitive potassium channels in the cell membrane. Nitroglycerin is similar in action and pharmacokinetics to nitroprusside…

…of action : <10 minutes. Effects Potent blood pressure lowering. Antianginal effect. Reduces afterload and preload. Effective in pulmonary edema. Can produce severe hypotension. Time to…

…Carefully titrated intravenous therapy when indicated Oral treatment and prompt follow up Main risk of management Overtreatment may impair autoregulation and cause ischemia Acute rapid…

…is demonstrated. ANOCA may occur in up to 70% of patients undergoing invasive coronary angiography, while approximately 25% of these patients have documented ischaemia. Among…

…of an angiographically obstructive lesion Coronary embolism or thrombus Epicardial coronary vasospasm Coronary microvascular dysfunction Spontaneous coronary artery dissection (SCAD) Standard angiography may fail to…

…regard to no flow time, low flow time, patient preferences, patient background, and the decision to initiate CPR is often ambiguous. Since the risk of…

…Acquisition of ECGs in pediatric patients is slightly different from adults, due to obvious anatomical differences. There are, however, no differences regarding the ECG grid…

…after 8–10 minutes of no flow (i.e. cardiac arrest without any circulation). These estimates should be viewed as approximations due to the following:…

…receive the impulse and spread it. If the impulse is discharged distal to the bifurcation of the bundle of His, the QRS complexes will be…

…Example of third degree AV block. Click to zoom. ECG features of third degree AV block On the ECG P waves have no relation to…

…No risk of hypercapnia and a normal blood gas Usually 94 to 98 percent An individually documented target prescription, for example in chronic hypercapnia Follow…

…diary of going to bed, getting up, medication intake, symptoms and any unusual activities. Interpretation A recording is acceptable if at least 70 % of the…

…Follow up after vascular surgery or endovascular intervention. Assessment of healing potential in ulcers and before deciding the level of amputation. Contraindications There are no…

Referensvärden A diagnosis of hypertension is not made on a single reading. It requires repeated measurements on at least two occasions, and preferably confirmation by…

…blood (always RhD negative to women of childbearing age) while awaiting the result. Equipment A large bore peripheral cannula — at least 1.3 mm (green…

…Indirect criteria after circulatory arrest, following a five minute no touch period The circulation at retrieval Maintained up to retrieval Ceased; warm ischaemic time is…

…cause carry at least as much weight as the laboratory values [1]. Grade Blood ketones pH or bicarbonate Consciousness : : : : Mild DKA 3 to 6 mmol…

…hours to days — to distinguish vestibular neuritis from posterior circulation infarction. The test presupposes that the patient has spontaneous nystagmus at the time of examination…

…at least three weeks of adequate anticoagulation before cardioversion — an INR ≥ 2.0 checked weekly on warfarin, or documented well managed DOAC therapy with no…

…first attempt fails. Desaturation and unrecognised oesophageal intubation are the two mechanisms that kill patients during airway management , and both are predictable. Indications Inability to…

…function and the rate of rise. Often outpatient or brief inpatient follow up depending on the clinical picture Moderate 6.0 to 6.4 mmol…

…at least 180/120 mmHg, but no absolute threshold defines the condition. A rapid rise in blood pressure can cause serious organ damage even at…

…at the same time. 6. Measure the glucose again after 10 to 15 minutes and repeat treatment until the patient has recovered. 7. Follow up…

…A markedly raised GGT with the other tests normal is most often enzyme induction by alcohol or drugs and is often of no clinical significance…

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

…30 mg of oral morphine per day, and 25 micrograms/hour to approximately 40–50 mg of oral morphine per day. Patches have no place…

…Confirm at least 2–3 cm of free fluid depth with no bowel in the path of the needle and measure the skin to peritoneum…

… pericardiocentesis is at best a bridge to it. A small (under 10 mm), loculated or purely posterior effusion with no safe route for puncture — surgical…

…a point with at least 15 mm depth of fluid throughout the respiratory cycle and where the lung does not come up against the probe…

…set at the fever threshold is always behind. Indications A patient who remains unconscious (with no meaningful response to speech) after the return of spontaneous…

…of calcium to albumin and lowers ionised calcium further; risk of tetany and seizures. Anuria or established renal failure. Without urine production there is no…

…currently the most widely used model. The aim of CHADS VASc is to identify patients at high risk of stroke, TIA or systemic thromboembolism and…

…5 to 15 minutes Duration of action 1.5 to 5 hours Delivery IV Dose 5–15 mg/hour IV infusion. Higher doses (up to…

…No data on QT prolongation or risk of torsade de pointes in PubMed. GnRH Antagonist Cancer (prostate) Synthetic decapeptide antagonist to gonadotropin releasing hormone (GnRH…

…for whom no practical risk prediction tool currently exists. At the other end, roughly two thirds of ICDs implanted for reduced LVEF never deliver an…

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

…or combinations of these mechanisms. Drug selection can therefore be tailored to the suspected mechanism. No antianginal class has demonstrated consistent superiority for symptom relief…

…There was no significant increase in fatal bleeding in the cited analyses. Nevertheless, the clinical importance of non fatal gastrointestinal and intracranial haemorrhage is substantial…

…participants who were described as frail generally had no more than mild frailty, limiting the applicability of trial findings to people with substantial functional impairment…

…et al, it is also reasonable to believe that patients with heart failure are at increased risk of decompensation if infected with COVID 19. Moreover…

…affecting at least two vascular beds. Carotid disease therefore commonly coexists with coronary artery disease (CAD), peripheral artery disease (PAD), and other manifestations of systemic…

…incidentally identified on a chest CT performed for another indication can also contribute to risk assessment. Visual reporting of coronary calcification using four categories—none…