Arrhythmias and arrhythmology Critical care Definition and pathophysiology Atrial fibrillation (AF) is the most frequent supraventricular arrhythmia in patients with acute coronary syndromes (ACS) and…

…hospital discharge is only 8.8%, which demonstrates that the majority of patients will not survive post resuscitation care. Among those who survive to hospitalization…

…place, the electrodes come off, the patient has not kept a diary. The set up and the instructions decide whether the investigation will be usable…

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…

…selected cases the patient can be observed without anticoagulation Red flags and pitfalls A normal saturation and a normal ECG do not exclude pulmonary embolism…

…2,3]. Grading Grade the severity by the most serious finding. A patient does not have to meet every criterion in a column. Clinical deterioration…

…A neutropenic patient with a suspected infection and organ dysfunction must therefore be managed as neutropenic sepsis even if the temperature criterion is not met…

…An intensive care patient in whom life sustaining treatment is withdrawn and total brain infarction is not expected to occur Death is confirmed by Direct…

…preferably two lines in a bleeding patient. A transfusion set with a filter. Blood components must not be given through a set without a filter…

…while swelling is progressing. Take care in impaired sensation (neuropathy, spinal cord injury) — the patient does not feel the pressure sore. Preparation and equipment Material…

…wards a substantial proportion of older patients are affected, and the incidence is particularly high after hip fracture, major surgery and intensive care [1,2]…

…experienced with the head impulse test; performed on the wrong patient or by an inexperienced examiner it is unreliable. A single central feature is enough…

…rheumatoid arthritis, ankylosing spondylitis MACOCHA is validated for the intensive care patient and totals 12 points: Mallampati III–IV (5 points), obstructive sleep apnoea syndrome…

…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…

…and bicarbonate ≥ 15 mmol/L Hyperosmolality Not required Effective osmolality 300 mosm/kg or total osmolality 320 mosm/kg Typical patient Often type 1 diabetes…

…instability — stabilise the patient first. CT before the puncture Swedish practice differs here from several international guidelines. The Swedish clinical care programme for bacterial CNS…

…the time the patient was last known to be well. Protect the patient from injury. Do not restrain the limbs and do not put anything…

…What determines whether the treatment is safe is not the starting dose but the system around the patient : that the weekly dose is adjusted in…

…As medium dose, and additionally severe hypertension (caution if patient on nonselective beta blockers). Dobutamine Cardiogenic shock Bradycardia (second line therapy) Stress testing (due to…

…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…

…of care. Fibrinolysis promotes thrombus dissolution by converting plasminogen to plasmin. Fibrin specific agents act preferentially when fibrin is present, whereas streptokinase is not fibrin…

…has profound implications for management and treatment of patients with acute coronary syndromes. Moreover, clinicians must clarify whether the ECG was recorded during chest pain…

…As medium dose, and additionally severe hypertension (caution if patient on nonselective beta blockers). Dobutamine Cardiogenic shock Bradycardia (second line therapy) Stress testing (due to…

…adoption has led to standardized reporting of eGFR in clinical laboratories, enhancing consistency in patient care. Non Invasiveness: The calculation relies on readily available clinical…

…even though incidence and prognosis vary widely between patient groups and care settings [2]. Practical first actions Do the following in parallel, not sequentially: 1…

…high risk of hypoglycaemia 8–12 mmol/L The critically ill patient in intensive care According to the local protocol Avoid tight targets in inpatients…

…at the appropriate level of care , with readiness for respiratory support. 5. Treatment of the alcohol use disorder and planned follow up , not merely detoxification…

…make sure that never happens, and to make sure the catheter does not become the patient's next focus of infection. Indications Infusion of vesicant…

…Do not treat asymptomatic bacteriuria. The exceptions are pregnancy and the period before a urological procedure. A positive urine dipstick in an older patient is…

…What usually goes wrong is not that the patient gets too little oxygen but that the prescription has no target — the nasal cannula stays in…

…after every attempt at reduction — otherwise it is impossible to determine afterwards whether a nerve injury was caused by the injury or by the treatment…

…intravascular cooling catheter . Both are controlled by feedback from the core temperature. Simple measures that are often enough: undressing the patient, lowering the room temperature…

…fraction (HFrEF), and post myocardial infarction (MI) care. Despite their proven morbidity and mortality benefits, their use is limited by specific adverse effects. Most of…

…term relationship with cardiovascular risk is therefore graded, although practical clinical care requires diagnostic and treatment thresholds. The 2024 European guideline defines hypertension as an…

…primary care personnel and home visits may reduce rehospitalization for recurrent ischaemia and infarction. Clinical Presentation and Symptoms Cardiac rehabilitation is initiated in patients recovering…

…resistance. The diagnosis is clinically important because secondary hypertension may be curable when its cause is clearly established and removed. Cure is not universal, however…

…before irrigating. 5. Let the pus drain out. Empty it with gentle pressure around the cavity, not by pressing hard on the surrounding healthy t

…also time limited by its very nature: a patient who has not responded within a couple of hours should be intubated, not given another hour…

…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…

…Pre hospital logistics Management Recommendation Level of evidence The pre hospital care of STEMI patients should be organized regionally (including all components from the emergency…

…AV block which may be unpleasant to the patient. This side effect lasts a few seconds. Case reports have indicated that the risk of high…

CPR Hypoxia and asphyxiation Hypoxia refers to a reduced partial pressure of oxygen in the blood. Asphyxia is characterized by insufficient ventilation, leading to hypoxia…

…R. Open chest versus closed chest cardiopulmonary resuscitation in trauma patients with signs of life upon hospital arrival: a retrospective multicenter study. Crit Care 2020…

…essential to provide supportive care and maintain vital functions artificially until the substance undergoes renal elimination, hepatic elimination or is removed by means of dialysis…

…changes when recording during chest pain is not consistent with myocardial ischemia. In other words, chest pain caused by ischemia will always result in ischemic…

…of the airway, breathing or circulation is usually an allergic reaction but not in itself anaphylaxis. The patient must nonetheless be observed, since the reaction…

…Availability in Sweden. Several of the drugs in this overview are not routinely marketed in Sweden and may require a named patient licence, among them…

…mortality, but most of the evidence was observational and the results must not be taken to mean that an electronic alert replaces clinical judgement [5]…

…ECG, and normal initial troponin may be observed in a chest pain unit or another non intensive care setting while serial testing is completed. Diagnostic…

…it was yesterday except that an electrical charge developed which fibrillated the heart. This electrical factor came and killed and disappeared and was not found…

…time, patient discomfort); falsely normal in microvascular dysfunction (diabetes, LVH, aortic stenosis, post MI stunning); blind to microvascular disease by design; low real world adoption…

…previous angina. Patients should be advised to seek emergency medical assistance rather than self presenting to an emergency department or contacting primary care first. If…

Critical care Myocardial ischemia and infarction Definition and Pathophysiology Cardiogenic shock is a state of inadequate tissue and end organ perfusion caused by cardiac insufficiency…

…90 mmHg—accompanied by signs of poor vital organ perfusion or frank shock states. In the specific context of perioperative care in patients with pulmonary…

…activity (PEA). Evaluation and Physical Examination The source material does not provide specific details regarding the physical examination maneuvers for patients with bradycardia. Diagnostics Electrocardiography…

…ousted repeatedly from the standard of care for these conditions. However, digoxin is still used in patients who do not achieve satisfactory effects using first…

…protocol. Usually a bolus followed by repeated doses or an infusion Suspected adrenal crisis Give the corticosteroid immediately. Do not wait for laboratory results. Take…

…an incomplete representation of atherogenic burden. Clinical Presentation and Symptoms ApoB elevation and increased non HDL C are laboratory abnormalities and do not produce specific

…is corroborated by the finding that 75% of patients have increased plasma levels of catecholamines. References A recent consensus document has been issued by the…

…The chain of care in acute STEMI Optimal care for patients with STEMI requires a well coordinated system involving both prehospital and hospital based services…