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

…which enables the clinician to examine intracardiac ECGs at any time. However, most clinicians who encounter patients with pacemakers only have access to conventional surface…

…clinicians will regularly encounter patients with CHD. Approximately 95% of all incident cases of congenital heart disease reach adulthood ( Mandalenakis et al ). The largest leap…

…prolonged and then shortened. The initial prolongation increases the length of the refractory period and the subsequent early impulse will therefore encounter refractory fibers. Thus…

…that cessation lowers the risk of peripheral artery disease, myocardial infarction, premature death, recurrent infarction and limb threatening complications. Among patients with established peripheral artery…

…around the isoelectric baseline. The risk of ventricular fibrillation is very high during torsade de pointes . ECG showing an episode of sinus rhythm (with multiple…

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

…in haematological malignancy. Investigation of dementia with biomarkers (amyloid, tau, phospho tau). Measurement of the opening pressure in suspected idiopathic intracranial hypertension. Therapeutic drainage in…

…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…

…An accelerating pattern of angina, with increasing frequency or severity Symptoms that awaken the patient from sleep Clinical assessment must be integrated with vital signs…

…of stroke and other thromboembolic events. Subclinical cerebral injury may contribute to vascular dementia, and thromboembolism may affect organs other than the brain. Patients with…

…Patients with previous acute coronary syndromes (ACS) Exercise stress testing is routinely performed after acute myocardial infarction in order to assess the presence of myocardial…

…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…

…Intermediate–high Stable Yes Raised Admission with monitoring. Be prepared for rescue thrombolysis Intermediate–low Stable One of the two positive Admission Low Stable No…

…in any of the following: A systolic blood pressure < 90 mmHg caused by the arrhythmia. Ongoing myocardial ischaemia with chest pain and ECG changes…

…signs of inflammation may be faint or absent. Take cultures immediately, but never let sampling, imaging, the blood count or contact with the patient's…

…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…

…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…

…Measure PEF or FEV1 if the patient can manage it without delaying treatment. 10. Call anaesthetics and intensive care early with life threatening features or…

…The biochemical grade alone does not indicate how acute the condition is. A patient with a chronic plasma sodium of 112 mmol/L may be…

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

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

…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…

…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…

…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…

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

…the population and diagnostic criteria. MINOCA accounts for approximately 1–14% of ACS presentations in different series and approximately 5–10% of patients presenting with…

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

…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…

…if the diary states when the patient fell asleep and got up. Holter ECG and longer rhythm monitoring Indications Palpitations, presyncope or syncope of suspected…

…to selected patients with an eGFR of 30 40 mL/min for lower urinary tract infection. At an eGFR <30 mL/min the antibacterial effect…

…with correctly performed compression. The reason compression nevertheless so often fails is that it is done wrongly: the patient pinches the nasal bone instead of…

…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…

…patient — stabilise first The induction of vomiting has no place in the modern treatment of poisoning. Charcoal also does not bind every poison. With the…

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

…because the sciatic nerve and the superior gluteal artery are avoided. The patient lies on their side with the knee slightly flexed. Place the palm…

…A fixation dressing for the nose, a vomit bowl, tissues, and a glass of water with a straw if the patient is awake and can…

…one: with an indication, a route of administration and a target range for the saturation . What usually goes wrong is not that the patient gets…

…capnography during sedation, with oxygen and a bag available. Drugs for procedural sedation and analgesia according to local practice and the guidelines of the Swedish…

…Marked atopic disease, particularly severe asthma and a history of anaphylaxis — a relative contraindication; the test is then performed with preparedness for anaphylaxis. An untreated…

…and start anaesthetic treatment with EEG After clinical cessation of the seizure Assess the recovery of consciousness. Urgent EEG if the patient does not wake…

…set at the fever threshold is always behind. Indications A patient who remains unconscious (with no meaningful response to speech) after the return of spontaneous…

…dose during the first week. Written patient information: the Waran booklet (the Swedish warfarin patient record) or its equivalent, with a weekly dose schedule. With…

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

…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…

…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…

…Weight loss was considered extremely difficult across patient categories. However, the emergence of incretin based therapies, starting with glucagon like peptide 1 receptor agonists (GLP…

…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…

…range of miscellaneous conditions. Because several mechanisms may coexist, diagnosis and classification must integrate haemodynamics with the patient’s clinical context and the results of…

…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…

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

…support capable of acquiring and transmitting a 12 lead ECG and obtaining medical authorization. Fibrinolysis reduces mortality in patients with STEMI, with the greatest benefit…

…unstable angina. Management begins in parallel with the diagnostic work up. Obtain an interpretable 12 lead ECG within 10 minutes of first medical contact, attach…

…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…

…the other arm. 2. Ankle pressure. Place the cuff just above the malleoli, with its lower edge about 2 cm above the tip of the…

…used for an initial assessment of pH and the metabolic component, but it should not be regarded as fully interchangeable with an arterial sample [3…

…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…

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