…free wall. Mediastinal trauma : Penetrating injuries to the mediastinum can cause tamponade. Post operative Complications : Post surgical complications following thoracic procedures can cause tamponade. Tamponade…

…meters per minute. Note that kilopond meters per minute can be converted to Watts (1 kilopond meter per minute = 0.1634 Watts). Protocols for…

…Atrial flutter, which often converts at low energy and is difficult to terminate pharmacologically. Ectopic atrial tachycardia or SVT that has not been terminated by…

…self adhesive multifunction pads. A separate three lead ECG cable connected to the patient — the device senses the rhythm through the cable, not through the…

…catheter over needle, 16–18 G, connected to tubing and a collection container. Sample tubes: an EDTA tube for the cell count, a serum tube…

Procedurer Compression is the treatment that heals venous leg ulcers; everything else is supportive. But the same compression applied to a limb with arterial insufficiency…

…menstrual status, previous smear results and any previous conisation. Procedure Inspection The patient lies in the lithotomy position, well covered. Say what you are do

…hydrogel or silicone elastomer coating may remain for up to twelve weeks, latex with a PTFE coating for a shorter period. Procedure In men 1…

…chest and connect it to the "OUT" terminal of the filter. The two connectors of the oesophageal electrode are connected to the inputs of the…

…Consent and the law Swedish law is based on presumed consent : a person who has not expressed opposition is presumed to have consented to donation…

Procedurer What determines the outcome of an emergency intubation is rarely the laryngoscopy itself but what was done before it: how well the patient was…

…Risk assessment is intended to identify patients most likely to benefit from early coronary angiography and revascularization, while avoiding unnecessary procedural complications and bleeding in…

…invasive fluoroscopic procedure in which contrast media are injected selectively into the epicardial coronary arteries through a catheter advanced from a peripheral artery to the…

…hours should have elapsed since the last dose before an invasive procedure. Exact intervals according to the local protocol or the on call coagulation service…

…injecting into it, and expect the procedure to hurt even so. Offer nitrous oxide, oral or intravenous analgesia, or procedural sedation in advance. Inadequate analgesia…

Procedurer Emptying the stomach has gone from routine to exception. Activated charcoal — in Sweden usually called medicinal charcoal — is the first line measure in decontamination…

…capacity, but it cannot compensate for an uncontrolled source of bleeding. Minimise the time to surgery, endoscopy, an obstetric procedure or angiographic intervention. Summon anaesthesia…

…open fracture. The anatomy of the nail apparatus The terminology is hard to follow without a picture, and several of the steps below refer to…

…either during the same procedure or through staged intervention. The rationale for complete revascularization is that untreated, flow limiting disease may continue to cause ischaemia…

…or vasomotor coronary disorders. The investigation should be undertaken when its diagnostic or therapeutic consequences are likely to outweigh procedural risks. This balance forms part…

…tubes according to local instructions, plus a formalin container for the biopsy. No. 11 scalpel for the skin incision, sterile dressings, pressure dressing. Procedure 1…

Procedurer A monoarthritis is septic until proven otherwise, and the only thing that proves otherwise is the synovial fluid. The aspiration is technically simple — what…

…the procedure is the wrong treatment : Aortic dissection with haemopericardium — drainage can increase the bleeding and worsen the prognosis. The patient must go to cardiothoracic…

…no absolute contraindications — the procedure is life saving and necessary respectively. Otherwise: Type Contraindication : : Absolute No safe pocket of fluid to puncture (no ultrasound verified…

…available. Drugs for procedural sedation and analgesia according to local practice and the guidelines of the Swedish Society of Anaesthesiology and Intensive Care Medicine (SFAI)…

…and infarction Definition and therapeutic rationale Multivessel coronary artery disease (CAD) refers to clinically significant atherosclerotic disease affecting two or more major epicardial coronary arteries…

…monopolar electrocautery below the umbilicus. Nevertheless, perioperative planning should be individualized according to the patient, device, procedure, and anticipated electrical environment. Preoperative evaluation Establish the…

…personnel must be well trained in resuscitation. Subject preparations The procedure must be explained carefully to the patient, who must also be informed that his…

…exercise stress testing is immense and the procedure may be used in numerous situations, ranging from health screening to assessment of symptoms after coronary artery…

…reserve (FFR), have been validated against outcomes and shown to outperform visual angiographic guidance in selecting lesions for percutaneous coronary intervention (PCI). Non hyperemic pressure…

Procedurer The ankle brachial index is the cheapest and most accessible method of objectively demonstrating peripheral arterial disease, and it is needed more often than…

…the hand secured with tape. Greater extension makes the artery harder to palpate. Procedure Catheter over needle (direct technique) 1. Palpate the course of the…

…a normal radiograph. Contraindications An open fracture or a wound that needs to be inspected — use a windowed splint or external fixation. Established or impending…

…for local anaesthesia, normal saline to flush all lumens, suture material or a securement device, transparent dressing. Monitoring throughout the procedure: ECG, pulse oximetry and…

Procedurer CPAP and NIV are two different treatments with different physiology, and the commonest source of error is confusing them. CPAP delivers a constant pressure…

Procedurer Cryotherapy destroys tissue through intracellular ice crystal formation and through microvascular thrombosis in the treated area. The method is quick, cheap and requires no…

…Ask the patient to keep the eyes open and look straight ahead — without open eyes there is no diagnosis. Procedure The Dix–Hallpike test 1…

Procedurer Edrophonium is a very short acting cholinesterase inhibitor: the effect appears within less than a minute and has gone after 5–10 minutes. That…

…bacteriuria. The exceptions are pregnancy and the period before a urological procedure. A positive urine dipstick in an older patient is difficult to interpret. Skin…

…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…

Procedurer The value of the exercise test lies not in ST depression alone but in the overall picture : exercise capacity, symptoms, blood pressure response, heart…

Procedurer The single most important step in any eye injury is to measure and document the visual acuity before anything else is done. The second…

…speculum with the handle parallel to the floor and the index finger supported against the patient's nose and cheek . Open the speculum upwards–downwards…

…Procedure Intramuscular — deltoid 1. Expose the whole shoulder; rolling up a sleeve creates a constriction that distorts the anatomy and tempts the operator to inject…

Procedurer The laryngeal mask is the single most important tool when intubation fails, since it restores oxygenation without requiring a view down into the larynx…

Procedurer What determines a lumbar puncture is rarely the needle itself. It is the decision whether to perform it now or after imaging, how the…

Procedurer The insertion itself is rarely the difficult part — it is the confirmation of the position that determines whether the tube is safe. A misplaced…

Procedurer Opioids have no standard dose. The effect varies tenfold between individuals, and the only way to find the right level is to give a…

…the middle ear may be open (a mastoid cavity, mastoidectomy). An only hearing ear. Relative (choose a manual technique or refer to ENT): Condition Reason…

…enough. Lidocaine 10 mg/mL to anaesthetise the marrow cavity in a conscious patient. Fixation material for the intraosseous needle. Procedure Peripheral venous cannula 1…

…or recurrence. Special situations Situation Comment : : Pregnancy Leg ultrasound first. CT pulmonary angiography or lung scintigraphy according to local procedure. Low molecular weight heparin, not…

Procedurer The test measures the ability of the adrenal cortex to respond to maximal ACTH stimulation, and it is rarely the injection itself that determines…

Procedurer The biopsy method determines what the pathologist can report. A shave biopsy of a pigmented lesion that turns out to be a melanoma can…

Procedurer Spirometry is the only investigation that distinguishes obstructive from restrictive impairment of lung function, and COPD cannot be diagnosed without it . The quality of…

Procedurer Since TTM2 the emphasis has shifted from cooling to fever prevention. Lowering the body temperature to 33 °C has not been shown to improve…

Procedurer Alkalinising the urine increases the excretion of weak acids by keeping them in a charged form in the tubular fluid, where they cannot be…

Procedurer Warfarin has a narrow therapeutic index, a half life of several days and more than a hundred clinically relevant interactions. What determines whether the…

…The HCM Risk SCD score aims to identify individuals with a high risk of SCD and determine whether an implantable cardioverter defibrillator (ICD) is warranted…

…lead to misclassification. Blood pressure should be measured with a validated and calibrated device using a consistent method for the individual patient. The recommended procedure…

…acute MI. For procedural subtypes (types 4a and 5), the clinical presentation is inherently linked to the context of the index revascularization procedure, occurring within…