…drugs, poisoning, withdrawal, surgery or several concurrent factors. A diagnosis of delirium is therefore the beginning of the investigation, not the end. In a frail…

…induce severe hypotension. • Clonidine is not recommended in most patients with severe cardiovascular disease or in those who are otherwise haemodynamically unstable. The benefit of…

…A patient with BPPV is usually relatively free of symptoms between the brief attacks. Lying down, turning over in bed or looking up triggers a…

…disease Verapamil or diltiazem When a beta blocker is contraindicated, for example in asthma Contraindicated in impaired left ventricular function and together with an intravenous…

…not the skin. Aspiration needle (iliac crest or sternal needle with stylet) and a Jamshidi type biopsy needle. Syringes: a small 5–10 mL syringe…

…wave to synchronise to; sync mode would block the shock entirely The patient Awake or sedated — requires sedation Unconscious In polymorphic VT, sync must be…

…heavy sedation, surgery — and cardiac arrest. Contraindications There are no absolute contraindications in the emergency situation. Consider alternatives when: Intubation is not consistent with the…

…Contraindications Absolute: that you cannot see the object, or cannot reach it with the instruments available. Do not then try "by feel" — refer to ENT…

…light sedation with a daily wake up trial shortens the time on the ventilator. See the article on confusion for the management of delirium in…

…in finger dislocation Procedural sedation Propofol, ketamine or a combination. It requires a fasting history, two people, full monitoring and airway preparedness With procedural sedation…

…Performance involves sedation (e.g., intravenous midazolam, propofol, or etomidate), routine blood pressure and oximetry monitoring, availability of atropine, isoproterenol, or transcutaneous pacing for post…

…6°C (97.7 99.7°F). It arises when heat production or acquisition surpasses the body's capacity for heat elimination. Hyperthermia can induce an inflammatory…

…so. Offer nitrous oxide, oral or intravenous analgesia, or procedural sedation in advance. Inadequate analgesia is the commonest reason for an incompletely performed drainage. Procedure…

…7.35 with raised pCO₂ Acute or acute on chronic hypercapnic respiratory failure Rapidly falling pH An urgent ventilatory problem Focal chest pain or unilaterally…

…period 24 to 72 hours Increasing autonomic hyperactivity and risk of complicated withdrawal 48 to 96 hours Delirium tremens with disorientation, fluctuating attention, agitation or…

…diagnosis or for grading. Antihistamines, corticosteroids, inhaled bronchodilators and nebulised adrenaline never replace intramuscular adrenaline [1,2]. Delayed administration of adrenaline is associated with more…

…emergency — but it should be changed or removed once the situation has stabilised. Preparation and equipment A central line set with a triple lumen catheter…

…Basal insulin (intermediate or long acting) Covers fasting glucose production Everyone with type 1 diabetes, always, including while fasting. Many with type 2 Mealtime insulin…

…Sedation precedes respiratory depression and is the early warning sign. Choice of agent Situation Choice Reason : : : An opioid naive adult with normal renal function Morphine…

…or reduce both Red flags and pitfalls A respiratory rate < 8/min, or an increasing level of sedation , are signs of overdose. Sedation precedes…

…spinal needle or the needle from a pericardiocentesis set), 10 mL and 20 mL syringes, a three way tap. A Seldinger set with a guidewire…

…temperature to 33 °C has not been shown to improve survival or the neurological outcome compared with keeping the patient normothermic — but fever after cardiac…

…and sedation: an opioid (morphine or fentanyl) combined with a benzodiazepine (midazolam or diazepam) is the commonest combination; propofol is used in units with airway…

…Sedation and Intubation : Along with anxiolytics, these measures minimize sympathetic surges [4]. Surgical Interventions : Stellate ganglion block (SGB) or cardiac surgical sympathetic denervation can be…