…with the patient fasting or having had a light breakfast according to local practice. Let the patient rest lying down or sitting for at least…

…in AF patients, the HAS BLED score demonstrated superior predictive performance compared to both HEMORR₂HAGES and ATRIA. The HAS BLED score had the highest net…

…those who did, only a minority had a reduced value — the majority of sudden cardiac deaths occur in patients with preserved LVEF, for whom no…

…of patients discharged with presumed non ischaemic chest pain were subsequently found to have had an infarction. Pathophysiological Considerations The central pathophysiological concern in the…

…during the stressful circumstances surrounding a sudden cardiac arrest, uncertainty may arise with regard to no flow time, low flow time, patient preferences, patient background…

…ECG changes were stable over a period of 30 years. The ST segment depressions were accentuated during exercise. The patient developed atrial fibrillation at 55…

…patient may remain substantial. At the same time, adverse effects such as hypotension, syncope, falls, and functional deterioration may have greater consequences in frail patients…

…or low flow periods. Under such circumstances, the efficacy of compressions and defibrillation diminishes considerably. Extracorporeal Life Support (ECLS) emerges as the sole therapeutic alternative…

…threats, or any situation in which the individual's life is (or perceived as it is) in danger. Takotsubo cardiomyopathy is much more common in…

…novo after delivery. New onset postpartum preeclampsia is increasingly recognized as a significant cause of maternal morbidity and mortality during the postpartum period. Maternal and…

…which at the time was primarily fibrinolysis (Wilner et al.). Their findings revealed that a substantial number of these patients had complete coronary artery occlusions…

…Myocardial Infarction Ticagrelor 60 mg twice daily is the recommended dose for extended treatment for patients who had a heart attack at least a year…

…third of the patients who ultimately had a favorable neurological recovery exhibited an abnormal pupillary reflex upon initial examination. Notably, 31.2% of patients discharged…

…For example, in the SYNTAX trial, patients with high scores had significantly higher mortality and MACE rates compared to those with low scores. Monitor Quality…

…instability. Fewer than 1% of patients with ST elevation myocardial infarction (STEMI) who reach the catheterization laboratory are found to have complete LMCA occlusion, likely…

…as prognostic markers during the disease course. In summary, the risk of severe disease and death is several times higher in patients with cardiovascular diseas

…Approximately 45% of participants had type 2 diabetes. Over a median follow up of 40.6 months, the time averaged LDL C difference between bempedoic…

…because the pericardium has had time to adapt. Hypotension and muffled heart sounds are important when present but are relatively insensitive findings. Some patients with…

…the critically ill patient, AF may be pre existing, newly detected for the first time, or newly developed during management of an acute illness. The…

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

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…

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

…resources have tightened the former 48 hour rule for patients with risk factors. Check what applies in your own region. The time limit is not…

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

…tap. A blood sample at the same time: serum albumin is mandatory in order to be able to calculate the SAAG. The patient lies supine…

…adrenaline or dopamine according to local practice, and does not replace pacing when the patient is markedly unstable. Transcutaneous pacing Equipment A defibrillator with a…

…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…

…urine measurement. Sudden polyuria is a warning sign of impending overcorrection. Grading Hyponatraemia is defined as a plasma sodium below 135 mmol/L. The biochemical…

Gastroenterologi & hepatologi Akutsjukvård Lathundar Immediate orientation Two questions govern the initial management: 1. Is the patient haemodynamically compromised, or are there signs of ongoing major…

…the validity before ordering blood ; an expired type and screen discovered when the patient is already bleeding costs precious time. Exact validity periods and the…

…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…

…physicians: recognise hypoactive delirium, stabilise the patient, work systematically through the possible causes, apply several non pharmacological measures at the same time, and use drugs…

…unrecognised oesophageal intubation are the two mechanisms that kill patients during airway management , and both are predictable. Indications Inability to protect the airway: reduced level…

…a patient performs progressively increasing external work, usually on a treadmill, while symptoms, a 12 lead ECG, heart rate and blood pressure are monitored. The…

…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)…

…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…

…by first establishing the time course and precipitating circumstances , and then selecting a targeted examination. The patient's description of the quality of the dizziness …

…20 % during the night. Pattern Nocturnal fall Comment : : : Dipper 10–20 % Normal Non dipper < 10 % Independent risk marker Reverse dipper ≤ 0 %, night time pressure…

…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…

…nasal fracture (absolute). An unsecured airway or haemodynamic instability — stabilise the patient first. Marked septal deviation towards the bleeding side (relative). Preparation and equipment Personal…

…blood pressure measurement. Resuscitation trolley with defibrillator, oxygen, suction and emergency drugs in the room. Staff with current CPR competence; a physician available. Patient preparation…

…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…

…refrain or adapt in: The patient does not consent — the examination must then not be carried out. Vaginismus or marked anxiety — plan for extra time…

…a slim patient. 4. Insert the needle perpendicularly , quickly and firmly, to its full length. 5. Aspiration is not needed for vaccination in the deltoid…

…and that the tubes go to the right place. In suspected bacterial meningitis it is the time to antibiotics that saves the patient — the puncture…

…Ask the patient to flex the head forward and swallow repeatedly , preferably with sips of water if swallowing is safe. Advance the tube in time…

…headache. High flow oxygen on a reservoir mask is the first line treatment during an attack and aborts most attacks within 15–20 minutes. An…

…force. The methods that work best exploit time, gravity and slow movement; those that fail usually do so because the patient tenses up with pain…

…the time of seizure onset, or the time the patient was last known to be well. Protect the patient from injury. Do not restrain the…

…temperature measurement and a target value that must never be exceeded, during the first 72 hours for as long as the patient remains unconscious. The…

…taken at the same time each day, usually in the evening so that a dose change can reach the patient the same day the result…

…is reasonable, although the optimal initial combination strategy remains uncertain. A beta blocker combined with a dihydropyridine CCB is appropriate for many patients. Long acting…

…equal to 2 mm Women (any age) V2 to V3 Greater than or equal to 1.5 mm All patients Other leads Greater than or…

…treatment inertia, in which patients remain on an inadequate single drug regimen for prolonged periods. The evidence supports improved blood pressure control and adherence, although…

…lipids and smoking cessation. Weight loss was considered extremely difficult across patient categories. However, the emergence of incretin based therapies, starting with glucagon like peptide…

…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…

…used in therapeutic studies of pulmonary arterial hypertension (PAH). The threshold is not absolute: patient phenotype, risk factors for heart failure with preserved ejection fraction…

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

…or surgical illness. Events may occur at any time, although clustering in the morning within several hours of awakening has been described. Atypical and painless…

…is determined by patient recognition and help seeking, pre hospital assessment and transport, diagnostic and treatment delays, and the time required for the selected treatment…