…set or a 6–8 F pigtail catheter, a drainage bag or a vacuum bottle. Drainage: a chest drain, an underwater seal unit, suture material…

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

…and repolarization generate electrical currents. It was also explained that the electrical currents are conducted all the way to the skin, because the tissues and…

…120 beats per minute. Chest pain (chest discomfort) Chest pain during exercise is one of the strongest predictors of coronary artery disease. The severity of…

…way to find the right level is to give a small dose, wait until it has worked, and assess the effect before the next one…

…hard to find in older women. Two things separate the safe catheterisation from the harmful one: never forcing against resistance, and never catheterising urethrally when…

…With ultrasound guidance, the point at which the fluid lies most superficially is chosen and the needle is followed all the way in, which has…

…of a fine needle, and collapsed veins mean that the fine needle is in addition the only one that will go in. The rule that…

…simple — bicarbonate and a look at the urine dipstick — but it fails routinely for one single reason: without normal potassium the urine cannot be alkalinised…

…One metabolic equivalent (1 MET) is defined as the amount of oxygen consumed while sitting at rest and is equal to 3.5 ml O2…

…perpendicular to the skin and rotate under even pressure until the resistance gives way — the dermis has then been passed and you are in the…

…the deep learning model. Predicting sudden cardiac arrest Sudden cardiac death (SCD) remains one of the most intractable challenges in clinical cardiology. Hundreds of thousands…

…ventricle with varying orientation. This organization allows the left ventricle to contract in a highly sophisticated and effective way (Figure 1). Myocardial fibers adjacent to…

ECG The artificial pacemaker is one of the great medical inventions of the 20th century. Cardiac pacing has evolved from a hazardous experiment in the…

Referensvärden Haemodynamic measurements become interpretable only when related to one another. A low blood pressure may be due to low flow, low vascular tone or…

Procedurer Oxygen is a drug and must be prescribed as one: with an indication, a route of administration and a target range for the saturation…

Echocardiography Echocardiographic assessment of regional contractile function Systolic ventricular function is one of the strongest predictors of total and cardiovascular mortality. Previous chapters have discussed…

…most dangerous asthma attack is the silent one. A patient who has become calm, quiet in the chest and stopped struggling may be about to…

…paroxysmal positional vertigo is the commonest cause of vertigo in primary care and one of the few diagnoses that can be cured on the spot…

…discussion: the ECG blog ECG The best ECG book is not the one making it simple In the thrilling and ever evolving field of medicine…

Echocardiography Dilated cardiomyopathy (DCM) Dilated cardiomyopathy (DCM) is defined as dilation of one or both ventricles. Dilation of the left ventricle is virtually always accompanied…

…in a healthy person and the probability is around 46 % that at least one will fall outside. The ranges below are guide values for adults…

…BLED score is a widely recognized and validated tool used to assess the one year risk of major bleeding in patients with atrial fibrillation (AF…

…is an LDL like circulating lipoprotein particle. It contains one molecule of apolipoprotein B covalently attached to apolipoprotein(a). The length of apolipoprotein(a) varies…

…Myocardial injury Myocardial injury is a biochemical diagnosis defined by at least one cardiac troponin value above the assay specific 99th percentile upper reference limit…

…Chest pain is one of the most common symptoms in the emergency department, as well as in primary health care. The cause (etiology) of chest…

…intervals, durations and rhythm This is arguably one of the most important chapters throughout this course. At the heart of ECG interpretation lies the ability…

…waves. The transducer is held with one hand and its position and angle are adjusted to send ultrasound waves through structures to be visualized. Ultrasound…

…in front of every ventricular complex? Normal values and differential diagnoses In sinus rhythm the rate is 50–100/min; a P wave precedes every…

…compression, cautery, anterior packing — and each step presupposes that the previous one has been done properly. Indications Ongoing epistaxis that has not stopped spontaneously. Recurrent…

…same foundation: an effective digital block and a tourniquet . Without a bloodless field one works by feel, and by feel nail spicules are left behind —…

…history of the disease. In lateral epicondylitis the effect is in fact worse than no treatment at all at one year . The injection is therefore…

…Thromboxane A2 promotes vasoconstriction and platelet aggregation. Because aspirin affects only one pathway of platelet activation, its antiplatelet effect is relatively limited compared with agents…

…States. In the United States, approximately one in four female deaths is attributed to CVD. The cardiovascular burden in women includes coronary heart disease, heart…

…also known as coronary artery disease, has been the number one killer worldwide since the 1960s. In 1948 the NHLBI initiated the Framingham Heart Study…

…high quality medical education simply. Life in the Fast Lane Australian site with one of the most impressive ECG libraries available. A must for anyone…

…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…

…the leads. Some leads may display all waves, whereas others might only display one of the waves. Regardless of which waves are visible, the wave…

…formerly termed Prinzmetal or variant angina, is myocardial ischaemia caused by transient abnormal vasoconstriction of one or more coronary arteries. Epicardial spasm produces a reversible…

…two different sets of piezoelectric crystals; one set for sending ultrasound and the other for analyzing reflected sound waves. The cardinal difference between continuous wave…

…has been recognized for almost 50 years, it is still one of the most frequently confused ECG findings. This is largely due to the fact…

…of cardiovascular disease. It has been the number one killer in Western and high income countries for more than half a century, causing approximately 20…

…The value of exercise stress testing is evident from the fact that exercise capacity (cardiopulmonary capacity) is one of the strongest predictors of cardiovascular and…

…left ventricle, as illustrated in Figure 1. One obvious disadvantage of M mode is that it only displays a single ultrasound line. Moreover, the ultrasound…

…ventricular tachycardia (VT) emerges. As evident, ventricular tachycardia may appear more polymorphic in one lead (the upper lead). ECG 2 . Although the signal in the…

…right bundle branch then runs deeper into the myocardium, where roughly one third of its length is located. It then runs closer to the endocardium…

…AKI, is a syndrome of rapidly deteriorating renal function. Management is governed not by the creatinine value alone but by the course, urine output, volume…

…flushing or angio oedema, together with at least one of the following: airway compromise respiratory compromise circulatory compromise severe gastrointestinal symptoms, particularly after exposure to…

…mmHg suggests vascular disease, and the arm with the higher reading is used thereafter Two to three measurements one minute apart, taking the mean of…

…in the entire chain. In massive haemorrhage a second problem is added: transfusion saves no one whose bleeding is not stopped, and it is the…

…estimate it as (age in years + 4) × 2 kg , but use a length based tool if one is available. This page is a rapid guide…

…products are to be delivered. 2. Designate a team leader and one person responsible for recording the transfusions, the sampling, the incoming products and contact…

…international guidelines on neutropenic fever [2]. The direct evidence for exactly one hour in neutropenic fever is limited, but delayed antibiotics are associated with a…

…and cardiovascular death — a patient with an eGFR of 70 and A3 is at higher risk than one with an eGFR of 50 and A1…

…a high mortality [1,2]. Give antibiotics immediately and aim for administration within one hour in septic shock, or when sepsis is judged certain or…

…required to up to 900 μg/day. Transdermal (one patch lasts for a week): • Catapress TTS 1 (0.1 mg/24hrs). • Catapress TTS 2 …

…Treatment can be started without interruption as continuation treatment after the initial one year treatment with Ticagrelor 90 mg or treatment with another adenosine diphosphate…

…to men but a substantially higher rupture risk; one guideline summary describes approximately a four fold greater risk. This difference informs the use of sex…

…Epidemiological studies have often described a J shaped association between consumption and cardiovascular outcomes, with apparently lower overall cardiovascular risk around one drink daily. However…

…inhibitor produces dual antiplatelet therapy (DAPT), while treatment with one antiplatelet drug constitutes single antiplatelet therapy (SAPT). The benefit of antiplatelet therapy must always be…