…studies of neutropenic patients. In septic shock, or where sepsis is highly likely, antibiotics must be given immediately [3]. This quick reference applies chiefly to…

…findings are absent in roughly half of patients with a central cause. A normal routine neurological examination is therefore not sufficient to exclude stroke [3]…

…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…

…infarction Use of ECG in acute coronary syndromes & chest pain patients An ECG must be performed on all patients seeking medical attention due to chest…

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

…likelihood of arrhythmia onset. However, beta blockers do not fully eliminate the risk. In LQT3 patients, where arrhythmias often occur at rest due to late…

…likelihood of arrhythmia onset. However, beta blockers do not completely eliminate the risk. In LQT3 patients, where arrhythmias often occur at rest due to late…

…the order in which measures are taken and the principles that are common to all protocols. Children, pregnant women and patients with advanced renal failure…

…likely to benefit from preventive drug therapy. Secondary prevention Although outside the principal scope of primary prevention, secondary prevention provides an important contrast. Patients with…

…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:…

…heterogeneous, and some patients may benefit from a more individualized selection strategy. When to Initiate Pharmacological Treatment Lifestyle intervention is an essential component of care…

…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…

…C by approximately 50–60%, including in patients receiving background statin therapy and in those unable to tolerate statins, provided that hepatic LDL receptor expression…

…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…

…the silent one. A patient who has become calm, quiet in the chest and stopped struggling may be about to stop breathing. Diminishing wheeze means…

…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…

…ABCDE assessment and document the time of seizure onset, or the time the patient was last known to be well. Protect the patient from injury…

…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…

…The accuracy of QT correction formulas can vary depending on the heart rate and individual patient characteristics. Bazett’s formula has a tendency to overcorrect…

…not backwards. Procedure Step 1 — compression Have the patient blow out the clot. The pinch is applied to the lower third of the nose, the…

…wrong blood being given to the wrong patient — a mislabelled tube, or an identity check performed at the nurses' station instead of at the bedside…

…main clinical rule Two questions determine the initial management: 1. Does the patient have severe neurological symptoms that may be due to the hyponatraemia? 2…

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…

…eyelid. Ask the patient to look down. Grasp the eyelashes, press gently downwards on the upper border of the tarsal plate with a cotton bud…

…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…

…to keep the dressing clean with a tracheostomy or copious secretions Subclavian vein Most comfortable for the patient, the most stable dressing, lowest risk of…

…during the days of illness (the patient's sick day rules) Vomiting or diarrhoea, unable to keep tablets down Parenteral hydrocortisone. The patient must have…

…venous measurement [5]. Treatment The awake patient who can swallow safely Give 15 to 20 g of rapid acting carbohydrate orally . Suitable options are: glucose

…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…

…due to the progressive nature of HCM. By combining these factors, the calculator generates a 5 year SCD risk percentage , which helps clinicians stratify patients…

…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…

…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…

…of many reported muscle symptoms remains uncertain. Randomized trials have shown muscle adverse event rates similar to those with placebo, whereas approximately 10% of patients…

…is thus a measure of systolic function. Strain and strain rate Myocardium deforms during systole and diastole. The deformation is due to contraction and relaxation…

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

…significant majority of these patients exhibit satisfactory neurological function upon discharge. Figure 1 . Expected cardiopulmonary function and alertness in decreasing body temperature according to HOPE…

…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…

…use of gel is recommended. In addition to the gel, it is important to apply some pressure when holding the transducer against the skin. Patients…

… the patient cooperates Intra articular local anaesthesia Lidocaine into the glenohumeral joint in shoulder dislocation, with an effect equivalent to sedation and fewer adverse effects…

…GY. A novel user friendly score (HAS BLED) to assess 1 year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey…

…Whether the patient has persistent or progressive disease suggestive of an advanced phenotype. Particular attention should be paid to potentially reversible causes and associated cardiovascular…

…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…

…principal causes of J waves, namely hypothermia, Brugada syndrome, early repolarization and hypercalcemia. Figure 1. Osborn wave (J wave). These waves occur due to hypothermia…

…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…

…Due to their clinical presentation, these patients are immediately referred to angiography but no coronary artery occlusion can be identified. Injection of contrast media into…

…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…

…ears and in the mouth. Nose 1. Ask the patient to blow the nose gently. Clear mucus with suction without pushing the object backwards. 2…

…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…