…during clinical encounters improves detection of risk factors such as elevated blood pressure and lipid abnormalities. CAC should therefore be integrated with clinical assessment and…

…most clinicians who encounter patients with pacemakers only have access to conventional surface ECGs. Being able to assess pacemaker function and perform troubleshooting should be…

…This has resulted in an increased prevalence of congenital heart disease in the general population, such that most clinicians will regularly encounter patients with CHD…

…refractory. In this case ( Figure 1 ) it encounters a refractory right bundle branch and therefore the impulse is conducted with right bundle branch block morphology…

…in patients with established atherosclerotic disease. Readiness and behavioural context A brief, structured intervention should be used whenever smoking is identified. During encounters with smokers…

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

…particularly in patients with irregular heart rhythms or low blood pressure. Additionally, individual variations in arterial compliance and pulse pressure can affect the accuracy of…

…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…

…via the His Purkinje system, and in most cases, there is no significant hemodynamic compromise. However, in cases of rapid AVNRT or in patients with…

…Evaluation and Physical Examination Patients with suspected ACS should undergo expedited emergency department assessment. The initial evaluation includes: Targeted medical history Physical examination Vital sign…

…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…

…3 days and the patient must not have experienced chest pain during the last 12 hours before exercise. Patients with unstable angina pectoris with high…

…Assess ventilation, airway protection, the expected course and the possibility of rapid reversal with an antidote. Intubation is recommended for neurological, respiratory or haemodynamic failure…

…molecular weight heparin with dose adjustment, or warfarin Subsegmental pulmonary embolism without deep vein thrombosis An individual assessment; in selected cases the patient can be…

…not 48. The 2024 ESC guidelines and several Swedish clinical knowledge resources have tightened the former 48 hour rule for patients with risk factors. Check…

…from the suspected focus, but avoid sampling that delays antibiotics 6 Take a targeted history and examine the patient, with particular attention to the mouth…

…the rectus sheath, and a cell count plus albumin on the sample. Indications Diagnostic paracentesis: Newly detected ascites — always. Every admission of a patient with…

…Bradyasystole during and after cardiac arrest with persisting electrical activity. Overdrive pacing in bradycardia dependent torsades de pointes. Standby pacing — pads applied but the device…

…rising pCO₂ during an ongoing severe asthma attack is an alarm sign. Early in a severe attack the patient usually hyperventilates and the pCO₂ is…

…a patient with moderate symptoms the physician must judge the likelihood that the symptoms really are caused by the hyponatraemia. With severe symptoms and marked…

…line if the patient is unstable or frequent blood gases are needed 3 Blood grouping and cross matching. Order red cells early with ongoing major…

…discovered when the patient is already bleeding costs precious time. Exact validity periods and the rules for electronic issue differ between regions — follow the local…

…closed circumferential cast , and the patient must leave with clear information about the symptoms that should make them seek help immediately. Indications An undisplaced or…

…In older patients delirium is often multifactorial. 7. Start non pharmacological treatment immediately , in parallel with the investigation. 8. Document the diagnosis and communicate it…

…kill patients during airway management , and both are predictable. Indications Inability to protect the airway: reduced level of consciousness, loss of pharyngeal reflexes, vomiting with…

…reserve and electrical stability. Clinical indications Suspected chronic coronary syndrome Exercise ECG may be used in selected patients with suspected chronic coronary syndrome when the…

…which the patient has symptoms suggestive of acute coronary syndrome (ACS), biochemical evidence of myocardial injury with corroborating evidence of infarction caused by ischaemia, and…

…dyspnoea in a patient with COPD. Pneumonia, heart failure, pulmonary embolism, pneumothorax and acute coronary syndrome must be actively considered [1]. Do the following early…

…attack and a movement that merely worsens dizziness that is already ongoing . A patient with BPPV is usually relatively free of symptoms between the brief…

…during the day and every 30 minutes at night , or alternatively every 15 and every 30 minutes respectively. Instruct the patient to stop, keep the…

…the drug is contraindicated at an eGFR <45 mL/min. A short course (no more than 7 days) may be given to selected patients with…

…septum and stop with correctly performed compression. The reason compression nevertheless so often fails is that it is done wrongly: the patient pinches the nasal…

…in the overall picture : exercise capacity, symptoms, blood pressure response, heart rate response, arrhythmias and recovery. A patient who stops at a low workload with…

…which the patient reaches hospital early. The benefit of both methods falls steeply with the time since ingestion, and both can harm the patient through…

…and technically correct performance is only half the task. The examination must be preceded by information about each step, take place with the patient's…

…The two commonest errors are that an intramuscular injection in fact ends up subcutaneously in a patient with a high BMI, and that the deltoid…

…of water with a straw if the patient is awake and can swallow. Gloves, an apron, a visor. Suction must be out and working before…

…requires special equipment and monitoring The nasal cannula, the simple mask and the reservoir mask deliver an FiO2 that varies with the patient's minute…

…gravity and slow movement; those that fail usually do so because the patient tenses up with pain, or because the operator pulls harder rather than…

…between 08:00 and 09:00 , with the patient fasting or having had a light breakfast according to local practice. Let the patient rest lying…

…as needed and start anaesthetic treatment with EEG After clinical cessation of the seizure Assess the recovery of consciousness. Urgent EEG if the patient does…

…survival or the neurological outcome compared with keeping the patient normothermic — but fever after cardiac arrest is harmful, it often arises spontaneously, and it must…

…dose in parallel. Procedure Initiation with a loading dose Used when a rapid effect is wanted and the patient is also receiving LMWH, for example…

…death, and among those who did, only a minority had a reduced value — the majority of sudden cardiac deaths occur in patients with preserved LVEF…

…50% in the cited North American guideline discussion. By contrast, the benefit of beta blockers in patients with CAD without previous MI and with normal…

…a primary differential diagnosis and presents with distinct characteristics compared to transmural ischemia [4, 5]. Acute Pericarditis vs. Acute Myocardial Infarction The ST segment elevation…

…In patients with a confirmed indication for treatment but blood pressure in the range of 120–139/70–89 mmHg, concomitant indications and overall cardiovascular…

…difficult across patient categories. However, the emergence of incretin based therapies, starting with glucagon like peptide 1 receptor agonists (GLP 1 RAs) and evolving into…

…the expected information is likely to change management. In patients with a very low probability of obstructive CAD, testing may generate false positive results and…

…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…

…Coarctation of the aorta and renovascular disease are important non endocrine causes, particularly in patients with resistant hypertension. Dietary sodium and potassium abnormalities and commonly…

…Sweating Nausea and vomiting Anxiety A sense of impending doom When STEMI begins during exertion, the symptoms generally do not resolve simply with cessation of…

…patient with symptoms of myocardial ischaemia. The immediate therapeutic objective is restoration of coronary blood flow to the infarct zone, thereby limiting infarct size and…

…particularly with ongoing or recurrent pain [1,3,4]. This quick reference gives internationally established doses. Drug availability, thrombolysis regimens, renal function thresholds and the…

…both the cause and the severity [1]. Three questions must be answered immediately: 1. Is there obstruction to urine flow? 2. Is the patient hypovolaemic…

…particularly in patients with marked tolerance. The most important measures in severe or complicated withdrawal are: 1. A benzodiazepine in a sufficient and repeated dose…

…and where needed a photoplethysmograph and a toe cuff. Preparation: The patient must have rested lying down for at least 10 minutes in a room…

…Does the result fit the patient? If not, check the sample type, supplemental oxygen, sampling technique, air bubbles and analytical delay, and compare with the…

…needle with stylet) and a Jamshidi type biopsy needle. Syringes: a small 5–10 mL syringe for the first aspirate, larger syringes for the tube…

…and does not interfere with ongoing CPR or airway management, no risk of pneumothorax Highest risk of thrombosis and contamination, immobilises the patient The right…