…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…

…COLCOT The COLCOT trial enrolled 4745 patients within 30 days of myocardial infarction. Participants received colchicine 0.5 mg once daily or placebo. The primary…

…by immediate bystander CPR. Cannulation should be completed within 60 minutes following the collapse. Preferential consideration is often given to younger patients, typically those below…

…European recommendations for initial combination therapy refer principally to confirmed blood pressure ≥140/90 mmHg. Blood pressure targets should therefore be individualized within the applicable…

…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…

…All patients with severe acute heart failure who receive levosimendan should be monitored invasively (e.g. arterial line, PiCCO, central venous catheter). The hemodynamic effects…

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

…be given to initiating therapy with the patient hospitalized and monitored for at least several days. Intravenous Loading For emergencies requiring rapid loading and effect…

…European Society for Cardiology) Preparations for the examination Patients referred for echocardiography should receive information regarding the conduction of the examination. Some patient engagement is…

…it might be wise to observe the patient for 24 hours (including ECG monitoring). In all other situations, the underlying condition should be targeted and…

…if the patient remains significantly decompensated, because recurrence is frequent while the precipitating haemodynamic and sympathetic abnormalities persist. Immediate cardioversion is reserved primarily for instability…

…knowledge resources have tightened the former 48 hour rule for patients with risk factors. Check what applies in your own region. The time limit is…

…is the first line measure in decontamination, and gastric lavage is today a rare procedure reserved for very serious poisonings in which the patient reaches…

…most consistent contemporary role is therefore the assessment of functional capacity, symptoms, haemodynamic responses, arrhythmias and prognosis, with diagnostic interpretation reserved for appropriately selected patients…

…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…

…The preferred terminology is contrast associated AKI when temporal association is present; contrast induced AKI should be reserved for the smaller subgroup in which iodinated…

…the elderly, or patients with diabetes [4]. Associated Findings: The sudden onset of symptoms coupled with diaphoresis should always raise concern for a cardiovascular cause…

…is then reserved for patients with a CHA₂DS₂ VA score of 0–1. Check what applies in your own region. Duration above the threshold or…

…boot), or a class 2–3 compression stocking. Tape measure for ankle circumference — this governs the choice of material and bandaging technique. Procedure Assessment 1…

…within 12 h of symptom onset in patients without contraindications. I A In the absence of ST segment elevation, primary PCI is indicated in patients…

…if some blood flow is maintained (for example, high quality cardiopulmonary resuscitation or partial ROSC), the midbrain may receive enough oxygen to preserve some pupillary…

…leads to a marked reduction in cell metabolism and thus prolongs survival. Myocardial stunning starts to normalize within minutes after the hypoxia is relieved. However…

…continue drug therapy. It is very common that patients with bradycardia have a strong indication for drugs that aggravate or even cause the bradycardia; in…

…to ticagrelor, although the comparative evidence between prasugrel and ticagrelor is conflicting. A 12 month regimen remains the default for most patients with ACS, including…

…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

…apparent, and pseudo resistant hypertension The term resistant hypertension should be reserved for patients in whom the diagnosis has been carefully confirmed. Apparent resistant hypertension…

…defibrillation (unsynchronized shock) is reserved for ventricular fibrillation, where urgent reversion to sinus rhythm is required. The rationale for electrical therapy over drugs is that…

…a clinical syndrome rather than a permanently stable state. Patients may remain stable for prolonged periods, but chronic coronary disease can progress or destabilize abruptly…

…whereas norepinephrine and/or inotropes are reserved for low output and hemodynamic instability. Evaluation and physical examination The objective of decongestion is clinical euvolemia rather…

…pain during the last 12 hours before exercise. Patients with unstable angina pectoris with high risk should not undergo exercise stress tests; these patients should…

…cases, enhanced elimination. For many poisonings, well delivered supportive treatment matters more than the antidote [1,2]. Telephone your national or regional poison control centre …

…probability in the stable patient The Wells criteria for pulmonary embolism: Criterion Points : : Clinical signs of deep vein thrombosis 3 Pulmonary embolism is the most…

Procedurer The commonest error in paracentesis is not performing it. Every patient admitted with ascites should undergo a diagnostic paracentesis , because spontaneous bacterial peritonitis often…

…patient — the device senses the rhythm through the cable, not through the pads. A pulse oximeter, a blood pressure cuff, and an arterial line for…

…consciousness and air entry repeatedly. 9. Measure PEF or FEV1 if the patient can manage it without delaying treatment. 10. Call anaesthetics and intensive care…

…take the plasma osmolality, urine osmolality and urine sodium before treatment. 5. With severe symptoms: give hypertonic saline immediately. Do not wait for a complete…

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…

…and antibody screening. If the screen is negative, a unit is selected electronically against the blood group Standard for planned transfusion in a patient without…

…10. Elevate the limb and inform the patient. Backslab or circumferential cast A dorsal backslab or another half slab for a fresh injury, acute swelling…

…frail older patient an apparently small insult — sleep deprivation, urinary retention or a new sedative drug, for example — may be enough to precipitate the condition…

…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…

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

…and the patient's usual saturation. Previous exacerbations and hospital admissions. Current inhaled treatment and adherence. Opioids, benzodiazepines and other sedating drugs. Thromboembolic risk, for…

…worse when the patient moves the head is therefore not evidence of BPPV. Step 2: decide whether HINTS may be used HINTS stands for Head…

…large for the available cuffs, and in a patient who does not tolerate repeated compression (for example marked thrombocytopenia). Set up and instructions Choose the…

…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…

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

…symptoms. 4. Blood pressure every second minute and on symptoms. 5. Ask actively about chest pain, breathlessness and leg fatigue; have the patient rate exertion

…Screening is for the asymptomatic. Symptoms must be investigated wherever in the screening interval the patient happens to be — a recently taken normal smear is…

…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…

…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…

…scale that discriminates within the acidic range — ordinary litmus paper that only shows acid or alkaline is not sufficient. A fixation dressing for the nose…

…of the saturation (see below). Oxygen does not relieve breathlessness in a patient who is not hypoxaemic. Breathlessness without hypoxaemia is not an indication for…

…The longer a joint remains dislocated, the harder the reduction becomes and the greater the risk of chondral and neurovascular injury. Aim for reduction within…

…Let the patient rest lying down or sitting for at least 15 minutes. 2. Insert a venous cannula. Wait a few minutes — the venepuncture itself…

…aspiration, hypoventilation, circulatory failure or an anticipated need for anaesthesia. Consider a 12 lead ECG when the acute situation allows, particularly before fosphenytoin, or where…

…patient, lowering the room temperature, a fan, paracetamol, cold infusions. A ventilator, an arterial line, a central venous catheter, ECG monitoring, blood gases. Drugs for…

…is a ready made plan for what happens when the INR runs away or the patient bleeds. In Sweden the treatment is usually managed from…

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

…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…