…neutropenic fever is limited, but delayed antibiotics are associated with a worse outcome in sepsis and in several studies of neutropenic patients. In septic shock…

…most important dangerous differential diagnosis. Clear focal neurological findings are absent in roughly half of patients with a central cause. A normal routine neurological examination…

…Some patients have frequent symptomatic episodes, whereas others have brief or asymptomatic episodes that are not detected during routine clinical assessment. The clinical burden of…

…why, or the patient at risk of carbon dioxide retention is given 15 litres on a reservoir mask and drifts off into a respiratory acidosis…

…10€) and may reduce morbidity and mortality substantially in patients with acute coronary syndromes. Importantly, the ECG findings dictate the management of acute coronary syndromes…

…widely recognized and validated tool used to assess the one year risk of major bleeding in patients with atrial fibrillation (AF) who are taking anticoagulants…

…independent cohort of 1,689 patients from the International LQTS Registry in Rochester, NY, USA. The validation study reported a C index of 0.69…

…independent cohort of 1,689 patients from the International LQTS Registry in Rochester, NY, USA. The validation study reported a C index of 0.69…

…coma may occur Mixed picture of DKA and HHS Overlap is common. Treat as mixed DKA and HHS if the patient has marked hyperosmolality together…

…which seeks to prevent the development of cardiovascular risk factors themselves, and from secondary prevention, which addresses patients with established disease to reduce recurrent events…

…appropriate first line pharmacological option when a patient is unable to tolerate any statin regimen. The treatment sequence for patients with chronic coronary syndrome is:…

…anticipated treatment benefit, and patient preferences. The source material describes hypertension using differing thresholds across international guidance. One framework defines confirmed hypertension as blood pressure…

…by the fact that the sickest patients are more often intubated [4]. Intubation is reasonable in: a reduced level of consciousness with inadequate protective reflexes…

…Addition of a PCSK9 inhibitor when the target remains unmet despite maximally tolerated statin therapy and ezetimibe. For patients with a recurrent atherothrombotic event while…

…fifth of adults during a hospital episode in international studies and is linked to substantial mortality, even though incidence and prognosis vary widely between patient…

…The grading must not be used mechanically. A patient with a plasma potassium of 6.2 mmol/L, new bradycardia and acute kidney injury may…

…patients at high risk for malignant arrhythmias should undergo continuous electrocardiogram monitoring throughout the entire peri operative period to assess rhythm stability [10]. References International…

…the findings of the ambulance crew The stated dose is often unreliable and must never be used on its own to declare the patient well…

…work of breathing, exhaustion and, in the most severe cases, hypotension, pneumothorax and respiratory arrest [1]. The first few minutes 1. Sit the patient up…

…of the skin over the puncture site. Marked haemodynamic instability — stabilise the patient first. CT before the puncture Swedish practice differs here from several international…

…without the patient regaining consciousness between them. Five minutes is the practical threshold for treatment, known as t1. After about 30 minutes of continuous convulsive…

…or itching without compromise of the airway, breathing or circulation is usually an allergic reaction but not in itself anaphylaxis. The patient must nonetheless be…

…is an uncommon cause of ventricular tachycardia, it is important to be able to differentiate these entities. The older the patient and the more significant…

…For patients with bundle branch blocks, the corresponding figure is 500 ms. The QT interval represents the time between the onset of ventricular depolarization and…

…compression. The reason compression nevertheless so often fails is that it is done wrongly: the patient pinches the nasal bone instead of the soft part…

…patient who declines blood transfusion. The decision must be documented and alternatives (iron, tranexamic acid, cell salvage, haemorrhage control) planned in advance. A history of…

…how acute the condition is. A patient with a chronic plasma sodium of 112 mmol/L may be relatively unaffected, while a rapid fall from…

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…

…precapillary PH, partly because this value has been used in therapeutic studies of pulmonary arterial hypertension (PAH). The threshold is not absolute: patient phenotype, risk…

…likelihood of atherosclerotic obstructive CAD. CAC is therefore not merely an incidental imaging finding; it can refine the decision to test and may identify patients…

…of hypercapnia and a normal blood gas Usually 94 to 98 percent An individually documented target prescription, for example in chronic hypercapnia Follow the patient…

…against the band and the chin in the rest. Support your working hand against the patient's zygoma or the bridge of the nose. 4…

…and the donor care The time from withdrawal of treatment to circulatory arrest Indications An intensive care patient with severe brain injury in whom total…

…often the very question at issue A patient who needs steroid cover simply to get through the day of the test can therefore be given…

…those who did, only a minority had a reduced value — the majority of sudden cardiac deaths occur in patients with preserved LVEF, for whom no…

…compressible if bleeding occurs, low risk of pneumothorax Uncomfortable for an awake patient, harder to keep the dressing clean with a tracheostomy or copious secretions…

…test before stopping During and after the taper the patient must be informed about the stress dosing rules and about the symptoms of adrenal insufficiency…

…the sample and send a venous plasma glucose, but do not delay treatment of a neurologically compromised patient. Continuous glucose monitoring reflects interstitial glucose and…

…value of around 0.9 to 1.0 or higher in an adult trauma patient suggests significant hypovolaemia and an increased transfusion requirement. Pregnancy, medication…

…ICD) is warranted. The HCM Risk SCD calculator is validated to estimate the 5 year risk of SCD in patients with HCM. What is the…

…In stable patients, it is advisable to add therapy with beta blocking agents before full target doses of ACE inhibitors are reached. Medication doses should…

…be individualized according to the patient, device, procedure, and anticipated electrical environment. Preoperative evaluation Establish the nature and function of the device The following should…

…Chinese and Malay patients, may have higher statin blood levels; lower starting doses are therefore appropriate. Drug interactions are particularly important. Inhibition of cytochrome P…

…cardiac index is cardiac output normalized to body surface area. The ultrasound system calculates body surface area using the patient's sex, weight and height…

…tailored to the patient's needs. Programming is done through an external device that communicates wirelessly with the pacemaker. A wide range of settings can…

…arrests, the survival rate stands at 73% (Podsiadlo et al.). A significant majority of these patients exhibit satisfactory neurological function upon discharge. Figure 1 . Expected…

…detail. Symptom during exercise stress testing Perceived exertion The patient's perceived exertion is a way of estimating the intensity of the physical activity. It…

…RWT (Relative Weight Thickness), provided that the patient's weight, height and sex are entered. RWT is a measure of the type of hypertrophy. Generally…

…the ribs increase, providing larger windows for the ultrasound beam. The operator can sit on either side of the patient, depending on preferences. The operator…

…rotation, and the patient resists internal rotation. Check the axillary nerve: sensation over the lateral part of the deltoid before and after the reduction , together…

…Lip GY. Performance of the HEMORR₂HAGES, ATRIA, and HAS BLED bleeding risk prediction scores in patients with atrial fibrillation undergoing anticoagulation: the AMADEUS study. J…

…may influence treatment selection and tolerability. Whether the patient has persistent or progressive disease suggestive of an advanced phenotype. Particular attention should be paid to…

…left ventricular hypertrophy. Among patients with NSTE ACS undergoing angiography, approximately 10% have no critical epicardial stenosis. In some of these patients, microvascular obstruction or…

…branch block. Paper speed 50 mm/s. Type 1 Brugada syndrome reminds somewhat of right bundle branch block (RBBB) in leads V1–V3, but the…

…could reasonably explain). The probability of hypertrophic cardiomyopathy is inversely related to age, such that the younger the patient presenting with hypertrophy, the more likely…

…function and catecholamine toxicity. The latter theory is corroborated by the finding that 75% of patients have increased plasma levels of catecholamines. References A recent…

…patient or by an inexperienced examiner it is unreliable. A single central feature is enough to proceed with urgent investigation , and a normal CT of…

…live insect As soon as possible — kill it first; the patient is in great distress Organic material (peas, beans) The same day — it swells when…

…department [1,3]. Step 1: confirm the blood pressure and stabilise the patient Immediate assessment 1. Assess airway, breathing, circulation and level of consciousness. 2…

…prevents the patient from tolerating compression. Preparation and equipment Equipment: a handheld Doppler probe 5–10 MHz, ultrasound gel, a blood pressure cuff of the…