…because the patient tenses up with pain, or because the operator pulls harder rather than more slowly. The neurovascular status must be documented before and…

…mode no shock at all is then delivered while the patient deteriorates. Indications Emergency, irrespective of duration and anticoagulation status: Tachyarrhythmia with haemodynamic compromise: hypotension…

…are not restricted to patients with symptoms. Current guidance supports revascularisation for significant left main stenosis irrespective of symptomatic status or the documented ischaemic burden…

…In contrast, patients with confirmed hypertension generally require BP lowering treatment without additional risk stratification for that treatment decision. Population to which SCORE2 and SCORE2…

…phlegmasia cerulea dolens, ergotism, hypercoagulable states or iatrogenic vascular injury. Acute occlusion may also occur in an artery with established collateral circulation, particularly an occluded…

…ABCDE assessment and document the time of seizure onset, or the time the patient was last known to be well. Protect the patient from injury…

…9. Check the distal neurovascular status again once the cast has set, and document it. 10. Elevate the limb and inform the patient. Backslab or…

…and contraindications, attach ECG monitoring and insert a venous cannula. 2. Document the baseline status of the chosen finding — measurement, photograph or video. 3. Give…

…moved to the evening. The fall can only be calculated if the diary states when the patient fell asleep and got up. Holter ECG and…

…acute illness The ventricular rate and its relationship to symptoms and haemodynamic status Whether heart failure is present and whether left ventricular systolic function is…

Cardiology Emergency medicine Definition and pathophysiology Acute pulmonary embolism (PE) is classified according to haemodynamic status, clinical severity, evidence of right ventricular (RV) dysfunction, and…

…questions must be answered immediately: 1. Is there obstruction to urine flow? 2. Is the patient hypovolaemic, adequately filled or fluid overloaded? 3. Is there…

…and functional deterioration may have greater consequences in frail patients. Clinical Assessment Frailty and Functional Status Treatment decisions should not be based on age alone…

…to transfer the patient to the ICU or CCU depends on the system of care and patient status. The absolute majority of patients should be…

…Physical Examination Prior to initiating an ACE inhibitor, it is essential to evaluate the patient's volume status. Because fluid retention can attenuate the effects…

…rectum. Ask about pregnancy, menstrual status, previous smear results and any previous conisation. Procedure Inspection The patient lies in the lithotomy position, well covered. Say…

…the patient first. CT before the puncture Swedish practice differs here from several international guidelines. The Swedish clinical care programme for bacterial CNS infections states…

…a patient at risk of rapid deterioration. Intraosseous access: Cardiac arrest where venous access is not immediately available. Shock, severe trauma, burns or status epilepticus…

…is metabolized to cyanide. Cyanid toxicity may be fatal (should be suspected if patient develops altered mental status and lactic acidosis). Fatal outcomes are rare…

…procedures. Both can improve coronary flow, exercise capacity and angina related health status, and both can reduce myocardial ischaemia during exertion or emotional stress. Neither…

…can develop despite a measurable or high blood alcohol concentration, particularly in patients with marked tolerance. The most important measures in severe or complicated withdrawal…

…pulse oximetry and blood pressure. Before puncture: check the coagulation status, give information and obtain consent if the patient is awake, and scan the vessel…

…disease — a risk of osteomyelitis and poor healing. Check the ankle brachial index and the foot status before any procedure on a toe. Critical ischaemia…

…particularly in patients with left ventricular dysfunction and/or MVD. Nevertheless, the optimal extent and timing of intervention depend on the clinical setting, haemodynamic status…

…Implantation history and current indication. Device function and battery status. Whether the patient is pacemaker dependent. Whether the device has been recently interrogated and whether…

…benign to highly malignant, which is why expeditious management is warranted. Initial management includes assessing the patient's clinical status (symptoms, hemodynamics), ECG and risk…

…require a named patient licence, among them clevidipine, nicardipine, fenoldopam, enalaprilat, phentolamine and sodium nitroprusside. Availability may change. Check the local formulary, the licensing status…

…and infarction Definition and Purpose Cardiac rehabilitation is a comprehensive, multidisciplinary secondary prevention intervention for patients with cardiovascular disease, including those recovering from myocardial infarction…

…Place in lipid lowering therapy General treatment sequence High intensity statin therapy remains the foundation of lipid lowering treatment for patients with chronic coronary syndrome…

…the absence of persistent ST segment elevation. This does not imply low risk: patients with NSTE ACS may have substantial myocardial ischaemia, dynamic ECG abnormalities…

…used to assess the morphology of valves, the presence of vegetations, hemodynamic status, and the extent of endocarditis. Endocarditis gives three typical findings on echocardiography…

…of cardiac arrest, focused echocardiography entails a swift evaluation of ventricular contractions and the status of the pericardium by an experienced clinician. The examination is…

…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…

…and from secondary prevention, which addresses patients with established disease to reduce recurrent events and mortality. Risk factor modification is therefore directed at identifying individuals…

…Various pharmaceutical agents, including epinephrine—administered to the vast majority of cardiac arrest patients—can induce such pupillary responses. In a comprehensive study by Javaudin…

…Cycle ergometer is preferred in Europe, while treadmill testing is predominant in the United States. Treadmill and cycle ergometer both have their advantages and disadvantages…

…utlility Monitoring MAP is essential for assessing adequate organ perfusion, especially in critically ill patients. A MAP of approximately 60 to 65 mmHg is generally…

…50 beats per minute in the first 4 to 6 hours after an acute infarction—patients may develop hypotension and signs of end organ hypoperfusion…

…therapy 18% Fixed dose combination with ezetimibe 38% Pooled analyses across different background therapies 17%–25% In patients with atherosclerotic vascular disease or familial hypercholesterolaemia…

…abdominal girth Early satiety Bendopnea Abdominal ascites Older patients may present atypically, with fatigue, depression, sleep disturbance or altered mental status rather than prominent breathlessness…

…dysfunction caused by pulmonary embolism Infiltrative cardiomyopathies, particularly cardiac amyloidosis Sepsis and other hyperdynamic states In cardiac amyloidosis, BNP or NT proBNP may be markedly…

…Weight status BMI (kg/m2) Obesity class Disease risk Underweight <18.5 — — Healthy weight 18.5–24.9 — — Overweight 25.0–29.9 — Increased Obesity…

…Clinical assessment should include functional status and walking capacity, because these may reveal “masked” PAD in patients who do not exert themselves sufficiently to provoke…

…recurrent infarction and limb threatening complications. Among patients with established peripheral artery disease, those who stop smoking have approximately twice the five year survival of…

…presenting feature. The source material emphasizes that patients and families should be educated to recognize chest discomfort or dyspnoea as potentially indicating myocardial infarction, particularly…

…particularly obstructive pulmonary disease, the use of theophylline, and elevated catecholamine states. EAT typically has an abrupt onset, although a brief warm up phase lasting…

…Activities should be selected according to the individual’s preferences, functional status and daily routine, because enjoyable and convenient activities are more likely to be…

…according to the guideline key points Patients with renal insufficiency and cardiovascular disease, irrespective of diabetes status The clearest and most consistent cardiovascular signal is…

…swallow, and postprandial states. In some instances, patients may present with adenosine sensitive syncope, a subtype of reflex syncope that manifests without a prodrome and…

…exercise tolerance test . Because the vast majority of all exercise stress tests in the United States are performed using a treadmill, the term treadmill test…

…from right intraventricular pressure. The systolic PA pressure is an indicator of cardiac hemodynamic status and may be estimated with echocardiography. The PASP is an…

…of congenital heart disease in the general population, such that most clinicians will regularly encounter patients with CHD. Approximately 95% of all incident cases of…

…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…

…myocardial tissue whose contractile function improves after coronary revascularization. This functional definition encompasses several physiological states. Brief coronary occlusion or relatively prolonged moderate ischemia may…

…end organ hypoperfusion, shock states, and pulmonary congestion. In pregnant patients presenting with suspected acute heart failure, urgent hospital admission and referral to an expert…

…85%). Many patients appreciate the exercise test because it offers them an opportunity to evaluate their performance and symptoms under the supervision of their clinician…

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…

…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…

…though cardioversion will occur Target rate in the acute phase: a resting ventricular rate < 110/min is a sufficient initial target in most patients…

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