…Clean the skin and apply the drape. Anaesthetise skin, subcutaneous tissue and then the periosteum at several points around the puncture site , and wait a…

…the threshold, but the threshold varies between regions. Infection of the skin over the puncture site. Marked haemodynamic instability — stabilise the patient first. CT before…

…Chronotropic support is given as an infusion of isoprenaline, adrenaline or dopamine according to local practice, and does not replace pacing when the patient is…

…inflamed tissue — the acidic environment inactivates the anaesthetic. Place a field block in healthy skin around the abscess instead of injecting into it, and expect…

…the most stable dressing, lowest risk of infection and thrombosis with prolonged dwell time Highest risk of pneumothorax, the vessel cannot be compressed after arterial…

…the only signs of infection. Corticosteroids and other immunosuppressive treatments can blunt the febrile response. A neutropenic patient with a suspected infection and organ dysfunction…

…modification of loading, eccentric exercise, an NSAID, an orthosis — has not given a sufficient effect. Contraindications Absolute: Cellulitis, a skin wound or other infection over…

…numerous local and systemic disorders. Accumulation of fluid in the pericardial space may lead to increased intrapericardial pressure, which in turn affects ventricular relaxation (and…

…myocardial tissue) and because they tend to accompany each other, the term perimyocarditis is often used. Image by Bruce Blausen, Blausen Gallery 2014. Causes of…

…The management of complicated withdrawal varies between regions and units. Follow the local protocol for choice of drug, dosing, route of administration and criteria for…

…of reperfusion treatment in ischaemic stroke, Nationell arbetsgrupp Stroke (the national stroke working group), version 4 of 27 February 2024. The local stroke protocol and…

…division of work between the ambulance service, the emergency department and the PCI laboratory may differ between Swedish regions. Always follow the local PCI and…

…cheap and requires no local anaesthetic — but it leaves no specimen . That makes the choice of lesion the critical point: never freeze anything whose diagnosis…

…function and other comorbidities Surgical risk and contraindications to prolonged dual antiplatelet therapy Patient preferences, local expertise and operator or institutional experience Assessment of coronary…

…the bleeding risk of the procedure and by renal function. In markedly reduced renal function (dabigatran at eGFR <30 mL/min, the other DOACs at…

…oxidative stress and immune activation progressively alter the local vascular environment. The extracellular matrix is an active component of lesion development rather than merely a…

…a sufficient initial target in most patients. Doses according to the local protocol and the Swedish medicines compendium (FASS). Rhythm control: the time limit before…

…Check the local formulary, the licensing status, the concentration, the dilution instructions and the local protocol before prescribing. Basic principles of treatment The patient should…

…in mitral and tricuspid inflow The echocardiographic counterpart of pulsus paradoxus Contraindications In overt tamponade with shock there are no absolute contraindications other than the…

…Heart failure, pulmonary oedema and other conditions with a high risk of fluid overload — a relative contraindication requiring invasive monitoring and slower administration. Significant metabolic…

…and imaging technique. Coronary fistulae represent abnormal communications between a coronary artery and a cardiac chamber or vessel. Other congenital anomalies include anomalous origin of…

…PCI and stent implantation produce local vascular injury and initiate a sustained inflammatory and reparative response. Proliferation and accumulation of tissue within the stent progressively…

…pharmacological stress Local expertise and adequate echocardiographic facilities are available Risk stratification is required in established or suspected CAD The extent or location of ischaemia…

…plaque and tissue factor bearing microparticles contribute to activation of coagulation. Plaque rupture is typically associated with a fibrin rich, red thrombus. The size and…

…risk factor [2] . This change reflects robust evidence that female sex alone, in the absence of other comorbidities, does not significantly increase stroke risk. Conversely…

…programs) and local level (e.g. EMS protocols, in hospital protocols, etc) is necessary to improve outcomes in out of hospital cardiac arrest (OHCA) and…

…team (CAT) and intensive care units and other units caring for resuscitated patients. Figure 1. The chain of survival in out of hospital cardiac arrest…

…often indicative of a noncardiac source [4]. 3. Pneumonia with Pleurisy Pain Characteristics: Pleuritic pain is a common presentation [2]. 4. Other Systemic/Local Causes…

…the patient to recite the months of the year backwards. A normal result does not exclude delirium, however, and an abnormal result is not specific…

…hydroxide ions are generated at the negative pole of the battery and produce a liquefactive necrosis that can reach the septal cartilage within a few…

…the last dose, the renal function and the severity of the bleeding 7 Manage antiplatelet drugs according to their indication. Do not routinely stop aspirin…

…follow the local protocol for exact infusion rates, electrolyte concentrations and level of care. This quick reference is intended primarily for adults and summarises the…

…typical of ischemia (but the sensitivity is low). U wave changes always accompany other ischemic ST T changes. They may occur in both NSTEMI and…

…set the COPD exacerbation apart from many other causes of acute dyspnoea: oxygen must be titrated cautiously and the blood gas determines the need for…

Info Table 1 provides a summary of the indications, contraindications, dosage, administration, warnings, precautions, and other relevant information for the drug Ticagrelor . Table 1 Summary…

…X linked or other non autosomal dominant mechanisms. Complex or multifactorial genetic architecture. The inheritance pattern affects the appropriate scope and duration of family surveillance…

…reflects the concentration of circulating atherogenic particles because each apoB containing particle carries one apoB molecule. LDL C, non HDL C and apoB are usually…

ECG Myocardial ischemia and infarction Myocardial ischemia: cellular changes, ECG signs and development of infarction Like all other cells in the human body, cardiac myocytes…

…history, a positive Dix–Hallpike test and the absence of other neurological findings. The treatment is a repositioning manoeuvre. Indications Brief attacks of vertigo, seconds…

…first sign of skin rash, mucosal lesions, or hypersensitivity. Interactions Pharmacodynamic interactions Anticoagulants, thrombolytics, or other platelet aggregation inhibitors: Salicylates inhibit platelet function and enhance…

…and progression of atherosclerotic disease in patients with established coronary or other atherosclerotic vascular disease. Antiplatelet therapy is a central component because platelet activation and…

…low density lipoprotein (VLDL) Chylomicrons and other triglyceride rich particles Thus, non HDL C provides a broader estimate of atherogenic cholesterol than LDL C alone…

…one pathway of platelet activation, its antiplatelet effect is relatively limited compared with agents that inhibit other platelet pathways. The distinction between primary and secondary…

…peripheral artery disease (PAD), and other manifestations of systemic atherosclerosis. The principal clinical concern is cerebral embolism or haemodynamic compromise leading to transient ischaemic attack…

…injury leads to release of cardiac troponin, but troponin elevation is not specific for myocardial infarction. Other conditions may produce cardiomyocyte injury and elevated troponin…

…FH). Heterozygous FH results in high LDL cholesterol levels (but nothing else) and increases the risk of acute myocardial infarction by more than 50 times…

…In the setting of acute coronary syndrome (ACS), DAPT is used to reduce recurrent myocardial infarction, stent thrombosis and other ischemic events after coronary angiography…

…and drug related presentations Severe hypertension may result from phaeochromocytoma, monoamine oxidase inhibitor crisis, cocaine intoxication, or other sympathomimetic exposure, including methamphetamine. Abrupt withdrawal of…

…and the maximum tolerated exercise time. Chronic limb threatening ischaemia CLTI occurs when resting perfusion is insufficient to meet the basal nutritional requirements of tissue…

…infection or other circumstances that may affect cessation or treatment monitoring. Single question screening can identify unhealthy drug use requiring counselling regarding cardiovascular effects and…

…beats per minute. Note that with a paper speed of 25 mm/s, which is standard in the US and many other countries, a 2…

…This is because the strong and oppositely directed forces tend to cancel each other out. However, the ECG may show features characteristic of biventricular hypertrophy…

…myocardial ischemia. Other symptoms include dyspnea, pain radiating to the left arm/shoulder/throat, palpitations, back pain and selected cases of upper abdominal pain. An…

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

…annihilate each other, producing two gamma photons emitted in opposite directions. PET scanners detect these gamma rays to construct images with high spatial and temporal…

…opposite angle of observation. Other vectors may interfere with the injury currents, and inhibit them from being detected by leads with opposite angles of observation…

…electrically dissociated from each other. This condition is referred to as atrioventricular (AV) dissociation. Importantly, for the ventricles to have any electrical (and thus pumping)…

…lowest rib and the iliac crest, at the end of expiration, with the tape horizontal and without compressing the skin. Ratios and other measurements Measurement…

…obstruction of the bowel or the urinary tract. Marked bradycardia, sick sinus syndrome or high grade AV block without pacemaker protection. Asthma and other marked…

…then 100 mg × 1 5–7 days Epiglottitis and other severe upper airway infection cefotaxime 1–2 g × 3 IV Depends on the diagnosis Always…