…of stroke. In patients with acute decompensated heart failure, AF with rapid ventricular response is particularly important. Cardioversion is generally not immediately indicated if the…

…as estimating the extent of ischemia. After revascularization procedures, stress testing is utilized to assess whether there is any residual ischemia or angina pectoris. Patients…

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…

…probability in the stable patient The Wells criteria for pulmonary embolism: Criterion Points : : Clinical signs of deep vein thrombosis 3 Pulmonary embolism is the most…

…anticoagulant? The unstable patient Immediate electrical cardioversion, without delay, in any of the following: A systolic blood pressure < 90 mmHg caused by the arrhythmia…

…Lathundar Key message Fever in a neutropenic patient is an emergency. Infection can progress rapidly, while the typical local signs of inflammation may be faint…

…on the sample. Indications Diagnostic paracentesis: Newly detected ascites — always. Every admission of a patient with known ascites. Clinical deterioration in a cirrhotic patient with…

…can keep a patient alive until a transvenous lead is in place — but only if it is working, and the commonest source of error is…

…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…

…gait instability The specificity of the symptoms is limited. In a patient with moderate symptoms the physician must judge the likelihood that the symptoms really…

…although the results are influenced by the fact that the sickest patients are more often intubated [4]. Intubation is reasonable in: a reduced level of…

…platelets: in ongoing bleeding with coagulopathy, or as part of balanced transfusion in massive haemorrhage. Transfusion thresholds in the stable, non bleeding patient Patient category…

…cause of pressure sores. 4. Dip the plaster in tepid water and squeeze out the excess without wringing. 5. Put the slab in place and…

…A diagnosis of delirium is therefore the beginning of the investigation, not the end. In a frail older patient an apparently small insult — sleep deprivation…

…shaped before induction , a syringe for the cuff, a cuff manometer. A laryngeal mask of the correct size as a rescue airway, and surgical airway…

…information independent of ischaemia. Maximal exercise capacity, expressed by exercise duration, workload or metabolic equivalents, is among the strongest predictors of mortality in patients with…

…of infarction caused by ischaemia, and no obstructive stenosis in a major epicardial coronary artery. Non obstructive disease is generally defined as the absence of…

…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…

…posterior circulation stroke is the most important dangerous differential diagnosis. Clear focal neurological findings are absent in roughly half of patients with a central cause…

…in primary care but interpreted as specialist investigations. Both fail more often for practical than for medical reasons: the cuff is in the wrong place…

…At a creatinine clearance <20 mL/min, consider an alternative treatment In aminoglycoside treatment of obese patients, an adjusted body weight is used: adjusted weight…

…as a solution has a good effect in anterior bleeding. Raise the chair so that the patient's nose is at your eye level. 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…

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

…are no absolute contraindications, but refrain or adapt in: The patient does not consent — the examination must then not be carried out. Vaginismus or marked…

…subcutaneously in a patient with a high BMI, and that the deltoid injection is placed too high — which causes the shoulder injury known as SIRVA…

…how the patient is positioned, which needle is chosen, and that the tubes go to the right place. In suspected bacterial meningitis it is the…

…drug administration when the patient cannot swallow safely, for example after a stroke. Sampling of gastric contents and evacuation in poisoning (see the separate text…

…that the prescription has no target — the nasal cannula stays in place for days without anyone asking why, or the patient at risk of carbon…

…so as not to reduce a fracture dislocation or to miss a posterior dislocation. The exceptions are an obvious recurrent dislocation in a patient with…

…Suspected secondary adrenal insufficiency in pituitary disease, after pituitary surgery or radiotherapy, or with suspected suppression of the HPA axis after long term glucocorticoid treatment…

…not restrain the limbs and do not put anything in the mouth. Suction the mouth as needed and place the patient in the recovery position…

…occurred in or out of hospital and whatever the initial rhythm. It applies to both shockable and non shockable initial rhythms. It is started as…

…as a potential interaction, and that there is a ready made plan for what happens when the INR runs away or the patient bleeds. In…

…deaths occur in patients with preserved LVEF, for whom no practical risk prediction tool currently exists. At the other end, roughly two thirds of ICDs…

…CCB therapy. Nicorandil and trimetazidine are additional options in selected patients. Treatment choices should be integrated with management of precipitating factors such as anaemia, uncontrolled…

…mm All patients Other leads Greater than or equal to 1 mm These criteria for the other leads apply in the absence of left ventricular…

…be initiated concurrently. In patients with a confirmed indication for treatment but blood pressure in the range of 120–139/70–89 mmHg, concomitant indications…

…profile, as the upper limit of the "healthy" range can still harbor significant metabolic risk. 3 For patients with a BMI below 35 kg/m²…

…chest pain. It is appropriate when the expected information is likely to change management. In patients with a very low probability of obstructive CAD, testing…

…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…

…approximately 20–25% of secondary hypertension cases. Coarctation of the aorta and renovascular disease are important non endocrine causes, particularly in patients with resistant hypertension…

…not every patient with an initial STEMI pattern has myocardial infarction as the final diagnosis. The underlying process usually involves acute thrombotic obstruction of an…

…begin as soon as possible, with a target of less than 10 minutes from STEMI diagnosis to the fibrinolytic bolus. In suitable systems, pre hospital…

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

…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…

…in patients with previous complicated withdrawal [4]. Untreated delirium tremens has historically carried a high mortality. With modern sedation, supportive treatment and treatment of the…

…and as a risk marker in diabetes and known atherosclerotic disease. An ABI ≤ 0.90 is diagnostic of peripheral arterial disease and at the same…

…stable patient A venous blood gas is often sufficient as the first sample Precise pCO₂ in suspected ventilatory failure Arterial blood gas Assessment of pO₂…

…Place the patient in the lateral position with the knees drawn up , or prone with a pillow under the pelvis. The lateral position is usually…

…risk of pneumothorax Highest risk of thrombosis and contamination, immobilises the patient The right internal jugular vein is the first choice in most situations. The…

…Inhaled and topical steroids in high doses can also cause systemic suppression. Corticosteroids mask fever and peritonitis. The abdomen of a patient on corticosteroids can…

…NIV IPAP 12–15 and EPAP 4–5 cmH₂O Increase the IPAP in steps of 2–3 cmH₂O every 5–10 min towards 20–25…

…confirmation of death is carried out in a formally unimpeachable way, and that the donor's organs are maintained physiologically for as long as the…

…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…

…available only as a named patient (licensed import) product, and the diagnosis instead rests on antibody analysis (AChR antibodies in about 80 % of generalised and…

…and in sync mode no shock at all is then delivered while the patient deteriorates. Indications Emergency, irrespective of duration and anticoagulation status: Tachyarrhythmia with…

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

…leakage of fluid causes a chemical burn Two or more magnets (including in different nostrils) Immediately — pressure necrosis across the septum A live insect As…

…chronic value [4]. The grading must not be used mechanically. A patient with a plasma potassium of 6.2 mmol/L, new bradycardia and acute…