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…

…due to the advent of more efficacious agents with wider therapeutic to toxic windows, and its routine use in adult patients is generally discouraged. However…

…inventions of the 20th century. Cardiac pacing has evolved from a hazardous experiment in the 1930s, to a routine, safe, and sophisticated treatment used worldwide…

…neurological findings are absent in roughly half of patients with a central cause. A normal routine neurological examination is therefore not sufficient to exclude stroke…

…anticoagulation can cause a stroke hours to weeks later. Everything else in the procedure is routine. Synchronised cardioversion or unsynchronised defibrillation Synchronised cardioversion Unsynchronised defibrillation…

…Routine gynaecological examination of asymptomatic women has not been shown to improve outcomes and is not part of the screening programme — screening consists of the…

…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…

…amputees, patients with hepatic cirrhosis — creatinine based eGFR substantially overestimates renal function. Staging of chronic kidney disease Stage eGFR Description : : : G1 ≥ 90 Normal or high…

…from the active edge, not from the centre Include epidermis and dermis Bullous dermatosis Two biopsies: one from a fresh blister (routine), one from perilesional…

…Recommendation Level of evidence The pre hospital care of STEMI patients should be organized regionally (including all components from the emergency medical dispatch to catheterization…

…least 70%, the reported 5 year ipsilateral stroke risk is 14.6%, and revascularisation may be beneficial in appropriately selected patients. In diabetes, carotid plaque…

…for routine coronary prevention because of fatal infections and high cost. Low dose methotrexate did not reduce cardiovascular outcomes, and several other agents, including pexelizumab…

…coronary driving pressure: distal coronary pressure minus coronary venous pressure Normal coronary driving pressure: mean aortic pressure minus coronary venous pressure In routine clinical practice…

…injury have not generally demonstrated sufficient clinical benefit for routine use. No reflow may also occur in association with other procedural complications, including distal embolization…

…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…

…adverse event rates similar to those with placebo, whereas approximately 10% of patients in registries and routine clinical practice report muscle symptoms. This discrepancy reflects…

…g., intravenous midazolam, propofol, or etomidate), routine blood pressure and oximetry monitoring, availability of atropine, isoproterenol, or transcutaneous pacing for post shock bradycardia, and use…

…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…

…heart failure. Routine opening of a persistently occluded infarct related artery in a stable and asymptomatic patient is by contrast not recommended [1,5]. STEMI…

…magnets (including in different nostrils) Immediately — pressure necrosis across the septum A live insect As soon as possible — kill it first; the patient is in…

Procedurer Catheterisation is straightforward in most patients and dangerous in a few. The male urethra is about 25 cm long with two curves and a…

…ICD) is warranted. The HCM Risk SCD calculator is validated to estimate the 5 year risk of SCD in patients with HCM. What is the…

…thresholds. Clinical Presentation and Symptoms Most AAAs are asymptomatic and are identified either during routine abdominal examination or incidentally on imaging performed for another indication…

…metabolism, yielding desethylamiodarone as a major active metabolite. Both the parent drug and its metabolite accumulate extensively in various tissues, including the liver, lung, fat…

…benefit of beta blockers in patients with CAD without previous MI and with normal LVEF is uncertain. Similarly, evidence for routine long term beta blocker…

…and ticagrelor is conflicting. A 12 month regimen remains the default for most patients with ACS, including those with NSTE ACS. It applies whether ACS…

…ASCVD develops. The clinical phenotype is driven principally by lifelong LDL C elevation and may be discovered through: Routine lipid testing showing severe hypercholesterolaemia. A…

…The length, trajectory and composition of the occluded segment, including calcium. The quality of the distal target vessel. The configuration and adequacy of collateral channels…

Cardiology Clinical medicine Definition and Clinical Rationale Physical activity comprises bodily movement that increases energy expenditure, including walking, household tasks, active commuting and recreational activities…

…cardiac metabolic efficiency, including increased oxygen delivery and beta hydroxybutyrate oxidation Reduced sodium hydrogen exchanger subtype 3 activity Attenuation of oxidative stress, inflammation and fibrosis…

…The largest absolute benefit is observed in patients at highest baseline risk, including older adults, although older patients also have more contraindications and a greater…

…onset: routine PCI of an occluded infarct related artery is not recommended in stable, asymptomatic patients without severe ischaemia. Evaluation and Physical Examination The initial…

…The strongest established predictors of ischaemic stroke and systemic embolism are previous stroke or TIA and mitral stenosis. In patients with AF and previous ischaemic…

…decades, the management of BrS has been fraught with controversies, particularly regarding the risk stratification of asymptomatic patients, the prognostic utility of electrophysiological studies (EPS)…