…differ substantially according to the clinical setting. Values obtained in the emergency department for acute dyspnoea should not be transferred directly to patients with less…

…to cause ischaemia, recurrent symptoms, myocardial infarction, or other major adverse cardiovascular events. Complete revascularization is therefore considered an important therapeutic objective, particularly in patients…

…from other fields (e.g. sepsis research) or physiological reasoning. Cardiac arrest care is advanced and should preferably only be conducted in specialized centers. Patients…

…24/7 without delay. I B Patients transferred to PCI centres can bypass the emergency department to undergo primary PCI without delay. I B Ambulance…

…Comment : : : Reticulocytes 20–100 ×10⁹/L Distinguishes a production defect from haemolysis or bleeding Ferritin 15–300 µg/L (women 10–150) An acute phase…

…dyspnoea improves and sympathetic activation subsides, making it difficult to determine whether AF initiated the deterioration or resulted from it. AF has important consequences beyond…

…survival. Patients with unstable angina pectoris with low risk (according to TIMI score or similar) may undergo stress testing when their clinical condition is stabilized…

…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…

…contraindication. The agent and dose are according to the local protocol. Alternatives when there is a contraindication: catheter directed treatment or surgical embolectomy where available…

…1 Cardioversion (electrical or pharmacological) can be performed directly. An anticoagulant is then given according to CHA₂DS₂ VA 24–48 hours, or risk factors present…

…a blood gas, coagulation tests and other investigations according to the clinical picture 5 Take cultures or molecular tests from the suspected focus, but avoid…

…hernia or visible abdominal wall collaterals (caput medusae) Puncture at least a few centimetres away from them Full bladder Have the patient void, or catheterise…

…an infusion of isoprenaline, adrenaline or dopamine according to local practice, and does not replace pacing when the patient is markedly unstable. Transcutaneous pacing Equipment…

…briefly and to the point: When did the deterioration begin, suddenly or over several days? Which drugs, and how many doses, has the patient taken…

…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…

…an anticipated difficult or prolonged endoscopic intervention a need for general anaesthesia for other reasons. Extubate as soon as it is safe to do so…

…transfusion accidents rarely stem from laboratory errors but from the wrong blood being given to the wrong patient — a mislabelled tube, or an identity check…

…the patient must leave with clear information about the symptoms that should make them seek help immediately. Indications An undisplaced or reduced fracture to be…

…distracted or cannot follow a simple instruction Altered awareness The patient is drowsy, difficult to rouse, hypervigilant, or has reduced orientation to the surroundings Other…

…oesophageal intubation are the two mechanisms that kill patients during airway management , and both are predictable. Indications Inability to protect the airway: reduced level of…

…syndrome Exercise ECG may be used in selected patients with suspected chronic coronary syndrome when the result is expected to influence diagnostic strategy or management…

…from a mismatch between myocardial oxygen supply and demand. The clinical history should therefore be examined for potential physiological or systemic stressors, with treatment directed…

…or invasive ventilation. Home oxygen and the patient's usual saturation. Previous exacerbations and hospital admissions. Current inhaled treatment and adherence. Opioids, benzodiazepines and other…

…and the Epley manoeuvre, since otherwise these examinations are easily applied to the wrong patient or misinterpreted [4]. Trigger or merely aggravation? Distinguish between a…

…every 30 minutes at night , or alternatively every 15 and every 30 minutes respectively. Instruct the patient to stop, keep the arm still and lowered…

…to 1.73 m². Recalculate in patients who are markedly larger or smaller than average. Higher doses may be required in the critically ill patient…

…not backwards. Procedure Step 1 — compression Have the patient blow out the clot. The pinch is applied to the lower third of the nose, the…

…with full preparedness Moderate to severe aortic stenosis without symptoms Individual assessment Hypertrophic cardiomyopathy with outflow tract obstruction Caution Tachyarrhythmia or bradyarrhythmia Rate control first…

…toxic dose of a substance that binds to charcoal, when it can be given early and the patient has an intact or a protected airway…

…screening interval the patient happens to be — a recently taken normal smear is no reason to refrain from investigating postmenopausal bleeding or a visible cervical…

…thumb and index finger, or compress the muscle in a slim patient. 4. Insert the needle perpendicularly , quickly and firmly, to its full length. 5…

…decision whether to perform it now or after imaging, how the patient is positioned, which needle is chosen, and that the tubes go to the…

…patent one. Ask the patient about a previous nasal fracture or unilateral nasal obstruction. 2. Measure the depth of insertion by laying the tube from…

…why, or the patient at risk of carbon dioxide retention is given 15 litres on a reservoir mask and drifts off into a respiratory acidosis…

…technique). The patient lies supine or sits. The upper arm is held adducted against the trunk and the elbow is flexed to 90 degrees. The…

…test to be interpretable. Procedure 1. Schedule the test in the morning, preferably starting between 08:00 and 09:00 , with the patient fasting or…

…the time of seizure onset, or the time the patient was last known to be well. Protect the patient from injury. Do not restrain the…

…to hypothermia , caution applies in: Ongoing uncontrolled bleeding or marked coagulopathy. Severe sepsis and septic shock. Already marked hypothermia from another cause — warm the patient…

…what happens when the INR runs away or the patient bleeds. In Sweden the treatment is usually managed from an anticoagulation clinic with dosing support…

…study, PET, SPECT, genetic profiling — add information but are too costly or invasive to screen a population. The surface ECG is the obvious cheap, standardized…

…blocker and/or a calcium channel blocker (CCB). If symptoms remain inadequately controlled, treatment should be reassessed and adapted. Escalation from monotherapy to combination therapy…

…any age) V2 to V3 Greater than or equal to 1.5 mm All patients Other leads Greater than or equal to 1 mm These…

…heterogeneous, and some patients may benefit from a more individualized selection strategy. When to Initiate Pharmacological Treatment Lifestyle intervention is an essential component of care…

…3 For patients with a BMI below 35 kg/m², direct assessments such as waist circumference, waist to hip ratio, or dual X ray absorptiometry…

…symptoms are severe, refractory to guideline directed medical therapy, occur at a low level of exertion, or are associated with high event risk. The apparent…

…flow are appropriate. Exercise PH is defined by an mPAP/cardiac output slope greater than 3 mmHg/L/min from rest to exercise. This response…

…likelihood of cure. When to investigate General indications Patients with suggestive signs, symptoms, or medical histories should undergo appropriate screening for secondary hypertension. The initial…

…usual location is the central chest or epigastrium. Radiation may occur to one or both arms and less commonly to the abdomen, back, neck or…

…or symptoms have been present for more than 2–3 hours. Patients with a working diagnosis of STEMI should, whenever possible, be transported directly to…

…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…

…malnourished, amputee or muscle wasted patients, an apparently normal creatinine may therefore correspond to markedly impaired renal function [3]. Urine output can change before creatinine…

…of another or an additional cause [1]. Delirium tremens most often begins after one to three days but can start earlier in patients with previous…

…the cuff over a protective dressing, or measure at the toe instead. Marked pain that prevents the patient from tolerating compression. Preparation and equipment Equipment:…

…Question Appropriate sample : : Metabolic acidosis or alkalosis in a haemodynamically stable patient A venous blood gas is often sufficient as the first sample Precise pCO₂…

…side (yields fibrotic, unrepresentative marrow — choose the other side). A patient who cannot lie still — plan for sedation rather than abandoning the procedure. Choice of…

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

…home Double or triple the oral daily dose during the days of illness (the patient's sick day rules) Vomiting or diarrhoea, unable to keep…

…SpO₂ 88–92% Hypoxaemic failure without hypercapnia CPAP or high flow nasal oxygen 5–10 cmH₂O According to oxygenation requirement SpO₂ 92–96% The pressure…

…diagnosis and the donor care The time from withdrawal of treatment to circulatory arrest Indications An intensive care patient with severe brain injury in whom…

…the principles that are common to all protocols. Children, pregnant women and patients with advanced renal failure, marked heart failure or circulatory shock require a…