…at follow up after one month, and at least annually thereafter, more often in impaired renal function. Red flags and pitfalls Atrial fibrillation with pre…

…least 38.0 degrees for at least one hour Neutropenia A neutrophil count below 0.5 × 10⁹/L, or below 1.0 × 10⁹/L with…

…A In the absence of ST segment elevation, primary PCI is indicated in patients with symptoms suggestive of acute myocardial infarction and at least one…

…Addition of a PCSK9 inhibitor when the target remains unmet despite maximally tolerated statin therapy and ezetimibe. For patients with a recurrent atherothrombotic event while…

…and potential adverse effects, consideration should be given to initiating therapy with the patient hospitalized and monitored for at least several days. Intravenous Loading For…

…for patients with a CHA₂DS₂ VA score of 0–1. Check what applies in your own region. Duration above the threshold or unknown: at least…

…70, who received bystander CPR and initially presented with a ventricular arrhythmia without return of spontaneous circulation within 15 minutes, were included. At 30 days…

…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…

…all patients with acute myocardial infarction the prevalence of right and left bundle branch block on arrival ECG is 6% and 7%, respectively. A proportion…

…by individual patient needs rather than by a distinct advantage of one drug over the other. Mathew et al. Milrinone as Compared with Dobutamine in…

…is competition between these latent pacemakers, the one with the fastest intrinsic rate of depolarization will be the pacemaker, which means that it usually is…

…responses, arrhythmias and prognosis, with diagnostic interpretation reserved for appropriately selected patients. Pathophysiological basis Exercise progressively increases myocardial oxygen demand through increases in heart rate…

…encounter patients with pacemakers only have access to conventional surface ECGs. Being able to assess pacemaker function and perform troubleshooting should be considered a basic…

…may be applied at all, and if so at what pressure. Palpable foot pulses are not an acceptable substitute, and in patients with diabetes or…

…contrast is considered causally responsible. This distinction is important because AKI after a contrast study frequently occurs in patients with several simultaneous renal insults. Infection…

…Notably, 31.2% of patients discharged with intact neurological function were observed to lack a pupillary reflex upon their initial presentation. An absent pupillary reflex…

…but it may be considered in selected patients with a high bleeding risk. Shorter approaches should therefore be reserved for circumstances in which bleeding concerns…

…more antihypertensive drugs from different classes at maximally tolerated doses, including a diuretic appropriate for kidney function. In patients with an estimated glomerular filtration rate…

…clinical populations include only a minority with symptoms having all of the traditional aggravating and relieving characteristics of angina; many patients report less characteristic symptoms…

…In patients with previous myocardial infarction and residual inflammation, defined by hsCRP ≥2 mg/L, it produced a modest reduction in a composite of cardiovascular…

…should receive information regarding the conduction of the examination. Some patient engagement is required to obtain all views and the best possible image quality. A…

…than the brain. Patients with AF in the setting of ACS have more comorbidities and a higher risk of complications than patients without AF; both…

…today a rare procedure reserved for very serious poisonings in which the patient reaches hospital early. The benefit of both methods falls steeply with the…

… relieved by rest/nitroglycerin [4], [6]. Sudden onset with diaphoresis [4]. Aortic Dissection Severe, often sharp pain radiating to the back [5]. N/A N…

…receive oxygen from collateral vessels. In cardiac arrest, there is no cerebral perfusion, with an equal degree of hypoxia in all neurons. There is one…

…compared with implementing an artificial pacemaker in order to be able to continue drug therapy. It is very common that patients with bradycardia have a…

…branch block. Cardiac monitoring is indicated for patients with a high pretest probability of arrhythmia causing syncope. In hospital monitoring is reserved for those wit

…reserved for ventricular fibrillation, where urgent reversion to sinus rhythm is required. The rationale for electrical therapy over drugs is that, under monitored conditions, a…

…of congestion Dyspnea is the dominant presenting symptom in acute decompensated heart failure and occurs in more than 90% of patients presenting with the syndrome…

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

…the findings of the ambulance crew The stated dose is often unreliable and must never be used on its own to declare the patient well…

…syndrome and in marked renal failure. Duration of treatment: at least 3 months. Extended treatment in unprovoked pulmonary embolism, a persisting risk factor, or recurrence…

…Ileus with distended bowel loops Ultrasound guidance mandatory; choose another site Scars, hernia or visible abdominal wall collaterals (caput medusae) Puncture at least a few…

…Bradycardia in a patient with a normal circulation and no symptoms requires no pacing, only monitoring and preparedness. Asystole with no electrical activity at all…

Lungmedicin Akutsjukvård Lathundar Immediate management The most dangerous asthma attack is the silent one. A patient who has become calm, quiet in the chest and…

…Documented development within less than 48 hours Chronic At least 48 hours Unknown Treated as chronic with respect to the correction limits The brain adapts…

…contrary been associated with more pneumonia and a longer stay, although the results are influenced by the fact that the sickest patients are more often…

…bore peripheral cannula — at least 1.3 mm (green) for rapid transfusion, preferably two lines in a bleeding patient. A transfusion set with a filter…

…therefore immobilised in a backslab or in a split cast, never in a closed circumferential cast , and the patient must leave with clear information about…

…delirium with a structured instrument , for example the 4AT or the CAM according to local protocol. 6. Look for several concurrent causes. In older patients…

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

…A substantial proportion present with NSTEMI, although STEMI occurs in approximately one third. Patients with MINOCA related STEMI generally do not have a prodrome before…

…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…

…Clear focal neurological findings are absent in roughly half of patients with a central cause. A normal routine neurological examination is therefore not sufficient to…

…acceptable if at least 70 % of the measurements are valid , with at least 20 daytime and 7 night time values, and with a measurement interval…

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

…patient blow out the clot. The pinch is applied to the lower third of the nose, the soft part , and held continuously for at least…

…recovery. A patient who stops at a low workload with a fall in blood pressure is a high risk patient even with normal ST segments…

…with the patient's ongoing consent, and be able to be stopped at any moment. A trauma informed approach also improves the technical quality — a…

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

…antibiotics that saves the patient — the puncture must never delay it. Indications Suspected meningitis or encephalitis. Suspected subarachnoid haemorrhage with a normal or non diagnostic…

…Procedure 1. Inspect both nasal passages and choose the more patent one. Ask the patient about a previous nasal fracture or unilateral nasal obstruction. 2…

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

…moved very slowly outwards in the horizontal plane , with pauses each time the patient tenses, until the joint slides back — usually at 70–110 deg

…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…

…is present with: an ongoing generalised tonic clonic seizure lasting at least 5 minutes, or repeated generalised tonic clonic seizures without the patient regaining consciousness…

…active prevention of fever — defined as a temperature above about 37.7–37.8 °C — for at least 72 hours in patients who remain unconscious…

…LMWH) for at least 5 days Mechanical aortic valve 2.5–3.5 Some centres use 2.0–3.0 with a modern bileaflet prosthesis…

…a reduced value — the majority of sudden cardiac deaths occur in patients with preserved LVEF, for whom no practical risk prediction tool currently exists. At…

…optimal initial combination strategy remains uncertain. A beta blocker combined with a dihydropyridine CCB is appropriate for many patients. Long acting nitrates or ranolazine may…