Procedurer Transcutaneous pacing takes seconds to start and can keep a patient alive until a transvenous lead is in place — but only if it is…

…the patient to blow the nose gently. Clear mucus with suction without pushing the object backwards. 2. Apply the anaesthetic and vasoconstrictor and wait 3…

…initiated by healthcare professionals. The purpose of basic cardiopulmonary resuscitation is to keep the person alive until resources and skills to provide ACLS arrive. However…

…in patients with acute coronary syndromes (ACS) and is also a common tachyarrhythmia requiring treatment in decompensated heart failure (DHF). In the critically ill patient…

…After revascularization procedures, stress testing is utilized to assess whether there is any residual ischemia or angina pectoris. Patients may undergo repeated stress tests to…

Akutsjukvård Lathundar Basic principle Manage the patient, not the list of poisons. Stabilisation according to ABCDE, the plasma glucose, a blood gas and an ECG…

…associated thrombosis. Warfarin in antiphospholipid syndrome and in marked renal failure. Duration of treatment: at least 3 months. Extended treatment in unprovoked pulmonary embolism, a…

…though cardioversion will occur Target rate in the acute phase: a resting ventricular rate < 110/min is a sufficient initial target in most patients…

…outcome in sepsis and in several studies of neutropenic patients. In septic shock, or where sepsis is highly likely, antibiotics must be given immediately [3]…

…Have the patient empty the bladder first. Procedure Choice of insertion site The left lower quadrant is the first choice : the abdominal wall is thinner…

…first few minutes 1. Sit the patient up and minimise physical exertion. 2. Attach continuous pulse oximetry and an ECG. 3. Give oxygen in hypoxaemia…

…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…

…peripheral cannulae. Consider an arterial line if the patient is unstable or frequent blood gases are needed 3 Blood grouping and cross matching. Order red…

Procedurer The most serious transfusion accidents rarely stem from laboratory errors but from the wrong blood being given to the wrong patient — a mislabelled tube…

Procedurer A cast should hold the fracture still and do nothing else. The two ways in which casting harms the patient are that it is…

…several factors Inattention is central. A simple check is to ask the patient to recite the months of the year backwards. A normal result does…

…patient and totals 12 points: Mallampati III–IV (5 points), obstructive sleep apnoea syndrome (2 points), reduced neck mobility (1 point), mouth opening under 3…

ECG Exercise stress test Definition and clinical role Exercise electrocardiographic testing is a standardized assessment in which a patient performs progressively increasing external work, usually…

…concept Myocardial infarction with non obstructive coronary arteries (MINOCA) describes a clinical presentation in which the patient has symptoms suggestive of acute coronary syndrome (ACS)…

…the same time, exacerbation is a clinical syndromic diagnosis, not a sufficient explanation for all acute dyspnoea in a patient with COPD. Pneumonia, heart failure…

…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]…

Procedurer Two recordings that are performed in primary care but interpreted as specialist investigations. Both fail more often for practical than for medical reasons: the…

…critically ill patient. Intravenous antibiotics Drug eGFR 90 60 89 30 59 15 29 <15 : : : : : : Benzylpenicillin 1 3 g three times daily 1 3 g…

…eye level. The patient sits upright and tilts the head forwards , not backwards. Procedure Step 1 — compression Have the patient blow out the clot. The…

…physician available. Patient preparation: A light meal is permitted; no large meal, no coffee and no nicotine in the preceding 2–3 hours. Comfortable clothing…

…measure in decontamination, and gastric lavage is today a rare procedure reserved for very serious poisonings in which the patient reaches hospital early. The benefit…

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…

…lower tip of the muscle insertion. 3. Stretch the skin with the thumb and index finger, or compress the muscle in a slim patient. 4…

…and a light protected tube if spectrophotometry is to be performed. Procedure 1. Position the patient correctly. The lateral position with the back towards you…

…pause. Position the patient semi recumbent with the chin slightly towards the chest — an extended neck directs the tube towards the larynx. Procedure 1. Inspect…

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…

Procedurer A dislocation is reduced with muscle relaxation, not with force. The methods that work best exploit time, gravity and slow movement; those that fail…

…given dexamethasone. That is the practical key: the patient does not have to be left unprotected for the test to be interpretable. Procedure 1. Schedule…

…seizure lasting at least 5 minutes, or repeated generalised tonic clonic seizures without the patient regaining consciousness between them. Five minutes is the practical threshold…

Procedurer Since TTM2 the emphasis has shifted from cooling to fever prevention. Lowering the body temperature to 33 °C has not been shown to improve…

…A bioprosthetic valve, the first 3 months 2.0–3.0 Thereafter usually an antiplatelet drug or nothing Preparation and equipment INR, full blood count…

…et al 1 ). Representative single beat morphs for a low risk patient (blue) and the corresponding high risk morph (red). Beyond the difference in R…

…optimal initial combination strategy remains uncertain. A beta blocker combined with a dihydropyridine CCB is appropriate for many patients. Long acting nitrates or ranolazine may…

…V2 to V3 Greater than or equal to 1.5 mm All patients Other leads Greater than or equal to 1 mm These criteria for…

…It is frequently clinically silent, which promotes both patient and clinician inertia and contributes to inadequate long term control. The treatment objective is individualized blood…

…the "healthy" range can still harbor significant metabolic risk. 3 For patients with a BMI below 35 kg/m², direct assessments such as waist circumference…

…In patients with a very low probability of obstructive CAD, testing may generate false positive results and unnecessary downstream procedures. In patients with a high…

…mechanisms may coexist, diagnosis and classification must integrate haemodynamics with the patient’s clinical context and the results of all relevant investigations. Haemodynamic definition At…

…identifiable underlying cause. It should be considered in every patient with newly diagnosed or referred hypertension, with particular vigilance when the clinical history includes hypokalaemia…

…Most patients with this working diagnosis subsequently develop myocardial necrosis and cardiac troponin elevation, although not every patient with an initial STEMI pattern has myocardial…

…cardiogenic shock is present, or symptoms have been present for more than 2–3 hours. Patients with a working diagnosis of STEMI should, whenever possible…

…2. Obtain a 12 lead ECG within 10 minutes. 3. Attach defibrillator pads if the patient is unstable or at marked risk of arrhythmia. 4…

…gives the higher stage. A patient can thus be stage 3 by urine output despite a less marked rise in creatinine. Limitations of creatinine and…

…the aim should be a calm, mildly somnolent but rousable patient, while ventilation, circulation and underlying disease are monitored [3]. The management of complicated withdrawal…

Procedurer The ankle brachial index is the cheapest and most accessible method of objectively demonstrating peripheral arterial disease, and it is needed more often than…

…failure and marked respiratory failure [3,4]. Question Appropriate sample : : Metabolic acidosis or alkalosis in a haemodynamically stable patient A venous blood gas is often…

…dressings, pressure dressing. Procedure 1. Place the patient in the lateral position with the knees drawn up , or prone with a pillow under the pelvis…

…throughout the procedure: ECG, pulse oximetry and blood pressure. Before puncture: check the coagulation status, give information and obtain consent if the patient is awake…

…a prolonged taper 3 weeks, prednisolone ≥ 5 mg/day Substantial A stepwise taper. More quickly down to the physiological level, then slowly Months to years…

Procedurer CPAP and NIV are two different treatments with different physiology, and the commonest source of error is confusing them. CPAP delivers a constant pressure…

Procedurer The donation process begins long before any retrieval: it begins when someone in the intensive care unit identifies a possible donor and the deceased…

…as mixed DKA and HHS if the patient has marked hyperosmolality together with significant ketosis and acidosis. With blood ketones ≥ 3 mmol/L and acidosis…

Procedurer Edrophonium is a very short acting cholinesterase inhibitor: the effect appears within less than a minute and has gone after 5–10 minutes. That…

…anticoagulation can cause a stroke hours to weeks later. Everything else in the procedure is routine. Synchronised cardioversion or unsynchronised defibrillation Synchronised cardioversion Unsynchronised defibrillation…

…Look for hyphaema — blood with a fluid level in the anterior chamber, best seen with the patient sitting up. 3. Ocular movements in all directions…