…device or a pessary. Assessment of prolapse. Sampling for a suspected sexually transmitted infection — although chlamydia and gonorrhoea can be tested on urine or a…

…older protocols but is no longer routinely recommended — alkaline urine increases the precipitation of calcium phosphate. Contraindications Hypokalaemia — must be corrected first or in parallel…

…and establish the time course. 2. Measure the urine output. Perform a bladder scan in oliguria, anuria or unexplained AKI. 3. Assess the circulation and…

…or normal ↑ or normal Obstructive (tamponade, PE) ↓ ↑ ↑ ↓ Vital signs and measures of perfusion Parameter Normal Comment : : : Heart rate 50–100…

…Alternatively urine ketones ≥ 2+ if blood ketones are unavailable Blood ketones < 3.0 mmol/L Acid–base Venous pH < 7.3 and/or…

…and urine sodium before treatment. 5. With severe symptoms: give hypertonic saline immediately. Do not wait for a complete work up of the cause or…

…65 mmHg 80–85 mmHg in chronic hypertension or when there are signs of inadequate perfusion Urine output 0.5 mL/kg/h Lactate Falling…

…h, or anuria ≥ 12 h Other kidney related values The fractional excretion of sodium (FENa) = (urine Na × plasma creatinine) / (plasma Na × urine creatinine) × 100…

…retention. Chronic urinary retention with renal impairment or a large residual volume. A need for accurate measurement of urine output in a critically ill patient…

…fluid ounces of wine containing approximately 12% alcohol, or 1.5 fluid ounces of 40% distilled spirits. Habitual heavy consumption is defined in the source…

…Pneumonia, suspected atypical pathogen erythromycin 500 mg × 4 PO 5–7 days or doxycycline 200 mg × 1 (day 1), then 100 mg × 1 Pneumonia, severe…

…the patient last passed urine. Contact intensive care in circulatory compromise, serious arrhythmia, marked QRS widening, a sine wave pattern, or a need for repeated…

…kidneys towards higher pressures. Too rapid a normalisation can therefore cause cerebral, coronary or renal ischaemia. Neurological status, urine output, creatinine, acid–base status and…

…neurological signs, seizures, severe or sudden headache. Chest pain, back pain, dyspnoea, orthopnoea and new sweating. Oliguria, dark urine or rapidly developing swelling. Pregnancy, gestational…

…urine can be saved early for later targeted analysis. Initial monitoring and investigations Investigation Comment : : Plasma glucose Taken immediately and repeated in impaired consciousness, or…

…mmHg or the hypotension is marked. Do not wait for a central venous catheter Continuously Reassess the mental state, capillary refill, skin temperature, urine output…

…observed treatment or detection of prescribed drugs in blood or urine. The terms “controlled resistant hypertension,” referring to blood pressure controlled with four or more…

…Where resources permit, objective assessment may include directly observed treatment or detection of prescribed medications in blood or urine samples. In patients with an estimated…

…bezoars or is a sustained release formulation. Note: activated charcoal is ineffective against alcohols, lithium, and heavy metals. Enhance elimination Induce diuresis through urine alkalinization…

…levels do not have any effect on the ECG, nor cardiac rhythm, or impulse conduction. 2. Calcium Hypercalcemia Causes of hypercalcaemia Primary hyperparathyroidism and malignancies…