Procedurer For many patients a gynaecological examination is associated with a sense of exposure, and technically correct performance is only half the task. The examination…

…cardiovascular disease, including PAD Conversely, patients with CVD should be screened systematically for diabetes because undiagnosed T2DM is common and has major therapeutic and prognosti

…et al 1 ). Representative single beat morphs for a low risk patient (blue) and the corresponding high risk morph (red). Beyond the difference in R…

…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…

…an expired type and screen discovered when the patient is already bleeding costs precious time. Exact validity periods and the rules for electronic issue differ…

…marrow — choose the other side). A patient who cannot lie still — plan for sedation rather than abandoning the procedure. Choice of site The posterior superior…

…transient, self terminating AF during ST elevation myocardial infarction may indicate an increased long term risk of stroke. In patients with acute decompensated heart failure…

…by some patient populations. The sensitivity, specificity, risks, and results of the exercise test may be affected by patient characteristics. For example, exercising patients with…

…Suction and give oxygen as needed. Intubate for a threatened airway, a marked risk of aspiration, or failure that is not rapidly reversed by an…

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

…rule for patients with risk factors. Check what applies in your own region. The time limit is not a guarantee. Where the stroke risk is…

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

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

…Do not wait for the blood gas result before starting treatment. Clinical assessment History that affects the level of risk Ask briefly and to the…

…A patient with a chronic plasma sodium of 112 mmol/L may be relatively unaffected, while a rapid fall from 140 to 125 mmol/L…

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

…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…

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

…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…

…Detecting exercise induced arrhythmias Evaluating the blood pressure response Refining risk stratification and prognosis For patients with low or moderate pre test likelihood of obstructive…

…often female than patients with atherosclerotic mediated myocardial infarction. A history of cigarette smoking may be present despite relatively few other conventional atherosclerotic risk factors…

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

…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

…should prompt investigation for sleep apnoea, renal disease and secondary hypertension, and lead to one dose being moved to the evening. The fall can only…

…course (no more than 7 days) may be given to selected patients with an eGFR of 30 40 mL/min for lower urinary tract infection…

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

…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…

…measure in decontamination, and gastric lavage is today a rare procedure reserved for very serious poisonings in which the patient reaches hospital early. The benefit…

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

…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…

…according to local practice. Enteral nutrition and drug administration when the patient cannot swallow safely, for example after a stroke. Sampling of gastric contents and…

…target — the nasal cannula stays in place for days without anyone asking why, or the patient at risk of carbon dioxide retention is given 15…

…remains dislocated, the harder the reduction becomes and the greater the risk of chondral and neurovascular injury. Aim for reduction within a few hours. Contraindications…

…points — follow the local instructions, but where the response is equivocal both are valuable. 7. Observe the patient throughout the test and for 15 minutes

…5 minutes, or repeated generalised tonic clonic seizures without the patient regaining consciousness between them. Five minutes is the practical threshold for treatment, known as…

…target value that must never be exceeded, during the first 72 hours for as long as the patient remains unconscious. The evidence Trial Question Result …

…with a loading dose Used when a rapid effect is wanted and the patient is also receiving LMWH, for example in newly diagnosed venous thromboembolism…

…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…

…equal to 1.5 mm All patients Other leads Greater than or equal to 1 mm These criteria for the other leads apply in the…

…a major risk factor for atherosclerotic cardiovascular disease and contributes to microvascular and macrovascular complications. It is frequently clinically silent, which promotes both patient and…

…profile, as the upper limit of the "healthy" range can still harbor significant metabolic risk. 3 For patients with a BMI below 35 kg/m²…

…In patients with a high probability, testing may add little diagnostic value and invasive coronary angiography may be more appropriate when symptoms, risk or anatomical…

…recognizes vasoreactivity subgroups among patients with idiopathic PAH, including acute responders and non responders. Left heart disease is the most common risk factor for PH…

…considered in every patient with newly diagnosed or referred hypertension, with particular vigilance when the clinical history includes hypokalaemia. Endocrine disorders account for many secondary…

…region but typically does not radiate below the umbilicus. Epigastric or subxiphoid pain may be mistaken for indigestion. Associated manifestations include: Sweating Nausea and vomiting…

…bleeding risk is high, the diagnosis is uncertain, cardiogenic shock is present, or symptoms have been present for more than 2–3 hours. Patients with…

…lead ECG within 10 minutes. 3. Attach defibrillator pads if the patient is unstable or at marked risk of arrhythmia. 4. Take a full blood…

… 2. Is the patient hypovolaemic, adequately filled or fluid overloaded? 3. Is there, or is there approaching, an indication for dialysis? AKI occurs in about…

…6]. This explains why a history of previous withdrawal seizures or delirium tremens is one of the strongest risk markers for a new complicated withdrawal…

…Preparation: The patient must have rested lying down for at least 10 minutes in a room at a comfortable temperature — a cold foot gives falsely…

…A patient may therefore have both an acidosis and an alkalosis at the same time despite a normal pH. The lungs compensate for a primary…

…risk of pneumothorax Uncomfortable for an awake patient, harder to keep the dressing clean with a tracheostomy or copious secretions Subclavian vein Most comfortable for…

…taper the patient must be informed about the stress dosing rules and about the symptoms of adrenal insufficiency. Prophylaxis during longer corticosteroid treatment Risk Action…

…for the former, a COPD exacerbation with carbon dioxide retention for the latter. The treatment is also time limited by its very nature: a patient…

…the current transmission risk assessment. In DCD: patients in whom death must be confirmed after a 20 minute no touch period, for example after poisoning…

…for adults and summarises the order in which measures are taken and the principles that are common to all protocols. Children, pregnant women and patients…

…equipment Edrophonium 10 mg/mL, 1 mL (named patient product — order well in advance). Atropine 0.5 mg for premedication, plus further atropine drawn up…

…to 24 hours for patients with risk factors; cardioversion between 24 and 48 hours without ongoing anticoagulation is then reserved for patients with a CHA₂DS₂…

…or peaked pupil suggests perforation. Look for hyphaema — blood with a fluid level in the anterior chamber, best seen with the patient sitting up. 3…

…actively look for another , in the other nostril, in the ears and in the mouth. Nose 1. Ask the patient to blow the nose gently…