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

…develop rapidly, often within an hour of arterial occlusion. The classic clinical constellation is remembered as the “six Ps”: Pain Paresthesia Pallor Pulselessness Poikilothermia, or…

…1. Check the indication and contraindications, attach ECG monitoring and insert a venous cannula. 2. Document the baseline status of the chosen finding — measurement, photograph…

…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…

…cardiovascular risk varies considerably according to age and the presence of concomitant risk factors. In contrast, patients with confirmed hypertension generally require BP lowering treatment…

…before the first dose of benzodiazepine is given. Airway, breathing and circulation Perform an ABCDE assessment and document the time of seizure onset, or the…

…and more heat production — a risk of burns Document the distal neurovascular status before casting : sensation, motor function, pulses and capillary refill. Check the skin…

…if the diary states when the patient fell asleep and got up. Holter ECG and longer rhythm monitoring Indications Palpitations, presyncope or syncope of suspected…

…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…

…according to haemodynamic status, clinical severity, evidence of right ventricular (RV) dysfunction, and myocardial injury. This classification is central to determining the intensity of monitoring…

… 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…

…used in younger adults, whereas a markedly frail 65 year old may require the more cautious approach generally applied to older patients. Frailty is characterized…

…which demonstrates that the majority of patients will not survive post resuscitation care. Among those who survive to hospitalization, 50 65% die within 24 hours…

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

…examinations of the breasts, the genitalia and the rectum. Ask about pregnancy, menstrual status, previous smear results and any previous conisation. Procedure Inspection The patient…

…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…

…and monitor the patient closely to avoid cyanide toxicity. • Dose dependent reduction in coronary and renal perfusion. • Dose dependent elevation of intracranial pressure (ICP) and…

…disease is present in approximately 80% of patients. Evaluation and clinical assessment Clinical factors influencing treatment selection The following characteristics favour CABG when clinically and…

…in patients with previous complicated withdrawal [4]. Untreated delirium tremens has historically carried a high mortality. With modern sedation, supportive treatment and treatment of the…

…risk of pneumothorax Highest risk of thrombosis and contamination, immobilises the patient The right internal jugular vein is the first choice in most situations. The…

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

…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…

…Device function and battery status. Whether the patient is pacemaker dependent. Whether the device has been recently interrogated and whether any malfunction has been identified…

…Initial management includes assessing the patient's clinical status (symptoms, hemodynamics), ECG and risk factors (age, previous disease, medications, laboratory results, etc). Considering the ECG…

…Check the local formulary, the licensing status, the concentration, the dilution instructions and the local protocol before prescribing. Basic principles of treatment The patient should…

…to participation Occupational and sporting goals Current pharmacological treatment Early assessment of left ventricular ejection fraction is recommended before hospital discharge because the first we

…within 2 years in some clinical settings, while the broader lipid lowering recommendation refers to a recurrent event without requiring that it be of the…

…within 24 hours? Is the patient stable without high risk characteristics and therefore potentially suitable for a selective invasive approach? Is the clinical likelihood of…

…the median age of 70 years at the onset of the disease. Approximately 12% die within 30 days, compared to the 30 day mortality of…

…swift evaluation of ventricular contractions and the status of the pericardium by an experienced clinician. The examination is typically as brief as the intervals required…

…occur in patients with preserved LVEF, for whom no practical risk prediction tool currently exists. At the other end, roughly two thirds of ICDs implanted…

…which seeks to prevent the development of cardiovascular risk factors themselves, and from secondary prevention, which addresses patients with established disease to reduce recurrent events…

…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…

…conclusive if the achieved workload is sufficient to provoke symptoms/signs that are not noticeable during rest. As a rule of thumb, the patient must…

…in patients with irregular heart rhythms or low blood pressure. Additionally, individual variations in arterial compliance and pulse pressure can affect the accuracy of MAP…

…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…

…95 and an absolute risk reduction of 2.4%. There was no statistical evidence that glycaemic status modified the treatment effect. Across the available evidence…

…occurs in more than 90% of patients presenting with the syndrome. Its severity and temporal pattern vary considerably. Symptoms of systemic venous congestion include: Peripheral…

…not apparent. Such a discrepancy should prompt consideration of an infiltrative cardiomyopathy within the appropriate clinical context. Several patient related factors influence interpretation. Natriuretic peptide…

…and heart failure Obesity increases the risk of HF and is common among patients with established HF, particularly HFpEF. Assessment of congestion may be difficult…

…intimal injury promote atherosclerosis. The principal anatomical distributions are: Abdominal aorta and iliac arteries, involved in approximately 30% of symptomatic patients. Femoral and popliteal arteries…

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

…in the source material. Delayed help seeking is associated with older age, female sex, Black race, lower socioeconomic or uninsured status, a history of angina…

…factors include pulmonary disorders, particularly obstructive pulmonary disease, the use of theophylline, and elevated catecholamine states. EAT typically has an abrupt onset, although a brief…

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

…failure across the ejection fraction spectrum, according to the guideline key points Patients with renal insufficiency and cardiovascular disease, irrespective of diabetes status The clearest…

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

…best predictors of risk for future adverse events in virtually all patient populations, including apparently healthy individuals. Exercise stress testing in the age of non…

…subtracting the pressure gradient across the valve (ΔP) from right intraventricular pressure. The systolic PA pressure is an indicator of cardiac hemodynamic status and…

…Roughly 25% of children with congenital heart disease require intervention during their first year of life ( Triedman et al ). According to the European Society for…

…The absence of chest pain does not exclude clinically important CCS. Silent or minimally symptomatic disease may occur in patients with diabetes and autonomic neuropathy…

…This functional definition encompasses several physiological states. Brief coronary occlusion or relatively prolonged moderate ischemia may produce post ischemic stunning. In the absence of infarction…

…that the clinical evaluation must identify specific hemodynamic profiles: the presence of hypotension, end organ hypoperfusion, shock states, and pulmonary congestion. In pregnant patients presenting…

…Patients with previous acute coronary syndromes (ACS) Exercise stress testing is routinely performed after acute myocardial infarction in order to assess the presence of myocardial…

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…

…is the first choice in pregnancy and an alternative in cancer associated thrombosis. Warfarin in antiphospholipid syndrome and in marked renal failure. Duration of treatment…

…anticoagulant? The unstable patient Immediate electrical cardioversion, without delay, in any of the following: A systolic blood pressure < 90 mmHg caused by the arrhythmia…

…with the patient's own clinic delay empirical antibiotics [1]. A practical target: give the first dose of broad spectrum antibiotics within 60 minutes of…