…intensive care Intermediate–high Stable Yes Raised Admission with monitoring. Be prepared for rescue thrombolysis Intermediate–low Stable One of the two positive Admission Low…

…severe piperacillin–tazobactam 4 g × 4 IV Exacerbation of COPD with an indication for antibiotics amoxicillin 750 mg × 3 PO 5–7 days or doxycycline…

…for health care professionals. Contact the centre early in serious, unusual or unclear poisoning, with modified release preparations, mixed poisoning, pregnancy, children, a need for…

…a month Thumb ECG or event recorder, 2–4 weeks Less often, with syncope Implantable loop recorder Contraindications None. Practical obstacles are skin disease or…

…protocols. Children, pregnant women and patients with advanced renal failure, marked heart failure or circulatory shock require a specific protocol and early specialist involvement. DKA…

…bore peripheral cannula — at least 1.3 mm (green) for rapid transfusion, preferably two lines in a bleeding patient. A transfusion set with a filter…

…cost, adherence, pregnancy after the first trimester under specialist care). Rheumatic mitral stenosis with atrial fibrillation. In uncomplicated atrial fibrillation and in ordinary venous thromboembolism…

…Basic principles of treatment The patient should be managed in an emergency department, an intensive care unit, a coronary care unit or another setting that…

…the specific context of perioperative care in patients with pulmonary arterial hypertension (PAH), progression of right heart failure may indicate the need for inodilator therapy…

…chiefly to adults with neutropenia related to cancer treatment. Children, pregnant women, patients after allogeneic stem cell transplantation and patients treated with CAR T cells…

…ovarian insufficiency Hypertensive disorders of pregnancy Preeclampsia Preterm delivery Gestational diabetes Small for gestational age delivery Placental abruption Pregnancy loss Polycystic ovary syndrome Functional hypothalamic…

…symptoms are particularly important because of the increased risk of cerebrovascular complications. Seizures in a patient with preeclampsia indicate eclampsia. Postpartum disease is clinically important…

…pads should be positioned as standard, and defibrillation energy levels should remain consistent with those used for non pregnant adults. The fetus is not harmed…

…may be required in some patients. Adverse effects Tachycardia. Headache. Flushing. Edema. Dizziness. Caution Should be used cautiously in patients with myocardial ischemia and/or…

…including in pregnancy. Postoperative hypertension. Mechanism of action Combined beta adrenergic and alpha adrenergic blocker with rapid onset of action. Labetalol has less antihypertensive efficacy…

…based on HbA1c. Albumin affects the total calcium — use the ionised calcium or correct for albumin. Biotin supplements interfere with many immunoassays, including troponin and…

…for example in pregnancy, acute glomerular disease or scleroderma renal crisis [1,2]. A hypertensive emergency means a markedly raised blood pressure together with ongoing…

…A high risk of aspiration: a non fasted patient, ileus, third trimester pregnancy, marked reflux. A need for high airway pressures, for example severe ARDS…

…pregnancy or malignancy. A markedly raised GGT with the other tests normal is most often enzyme induction by alcohol or drugs and is often of…

…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…

…for surgery Threshold for surgery Relevant patient category 27.5 mm/m 2 Turner syndrome 40 mm • Patients with mutations in TGFBR1, TGFBR2 or Loes…

…Severe heart failure. Doses 100 mg/day during the third trimester of pregnancy. Dosage Acute myocardial infarction: Initial loading dose: 300–500 mg as soon…

…Increase as necessary. Maximum dose: 5 mg iv every six hours. Adverse effects Severe hypotension. Contraindications • Contraindicated in pregnancy, severe renal artery stenosis, severe hyperkalemia. •…

…The risk of ACS is greatest during the third trimester and postpartum period, although SCAD may occur at any time during pregnancy or after delivery…

…contraindications for thrombolysis. Venous thromboembolism is a chronic and serious condition. Mortality in pulmonary embolism is up to 20%, and roughly 30% of patients with…

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…

…bleeding, or a smaller measured blood loss if there is physiological compromise. Do not wait for hypotension in young, pregnant or previously athletic patients. Beta…

Info This drug manual is provided for use in patients with hypertensive emergency (also referred to as hypertensive crisis or malignant hypertension ). Hypertensive emergency is…

…aorta Previous aortic trauma Pregnancy, particularly the third trimester Weightlifting Cocaine use Deceleration injury Systemic hypertension coexists in approximately 70% of patients with aortic dissection…

…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…

…neurological deficits. Neurological involvement Hypertensive encephalopathy may present with somnolence, lethargy, tonic–clonic seizures, cortical blindness, and, in advanced cases, loss of consciousness. Focal neurological…

Cardiology This drug manual is provided for use in patients with hypertensive emergency (also referred to as hypertensive crisis or malignant hypertension ). Hypertensive emergency is…

…cautiously in patients with high intracranial pressure or azotemia. • Should not be given to pregnant women. • Should not be given to patients with Leber optic…