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…

…compression. The reason compression nevertheless so often fails is that it is done wrongly: the patient pinches the nasal bone instead of the soft part…

…2. The initial part shows QRS complexes with similar morphology as ECG 1, likely presenting a supraventricular rhythm. Three short bursts of ventricular tachycardia occur…

…aphasia and radiological changes resembling ischaemic stroke. Glucose measurement is therefore always part of the initial stroke assessment [1]. Treat immediately when there are symptoms…

…5 mg/mL: clean with 3–4 swabs in wide circles and let it dry for a couple of minutes before the needle is inserted…

…much bicarbonate is given. Potassium replacement is not the management of a side effect; it is part of the treatment itself. Indications Salicylate poisoning with…

…for the assessment of valvular regurgitation. Part 1: aortic and pulmonary regurgitation (native valve disease). In European journal of echocardiography : the journal of the Working…

…segment depression in the inverted lead aVR). A notch is evident in the ascending part of the ST segment. A male patient (Figure 1) presented…

…previous complicated withdrawal [4]. Untreated delirium tremens has historically carried a high mortality. With modern sedation, supportive treatment and treatment of the precipitating illness the…

…vasoconstriction, arrhythmia, intra aortic balloon pump. Assessment of stroke volume variation as part of fluid management. Contraindications Infection, burn or trauma over the insertion site…

…Choice of site The posterior superior iliac spine is the standard site for both aspiration and biopsy in adults. Here the posterior part of the…

…retrograde (inverted) P waves, which can be located anywhere between the J point and the terminal part of the T wave. PR interval 0,22…

…This discrepancy reflects, at least in part, the nocebo effect : negative expectations, contextual cues and attribution of pre existing symptoms to the medication. No single…

…retrograde (inverted) P waves, which can be located anywhere between the J point and the terminal part of the T wave. PR interval 0,22…

…an indicator of cardiac hemodynamic status and may be estimated with echocardiography. The PASP is an independent predictor of survival and for elevated left ventricular…

…ventricle depolarizes after the left ventricle, allowing its electrical vectors to become evident. These vectors manifest in the later part of the QRS complex as…

…Moreover, the first part of the formula (0.5 • D blood ) can be approximated to 4, meaning that Formula 2 can be rewritten as follows…

…are capable of normalizing their membrane potentials immediately as oxygen becomes available. Recall that ST segment elevations also become normalized as a part of the…

…tragus and the area behind the pinna before the otoscope is inserted — mastoid erythema and a protruding ear are not part of the tympanic membrane…

…Vascular dysfunction Promotion of vascular calcification Albuminuria and proteinuria Neurohormonal activation Plasma volume expansion Myocardial remodelling and fibrosis These processes form part of the broader…

…creates three circular sections of the left ventricle named basal , mid cavity , and apical . These three parts are divided into a total of 17 segments …

…the past three decades, the management of BrS has been fraught with controversies, particularly regarding the risk stratification of asymptomatic patients, the prognostic utility of…

…reduced left ventricular ejection fraction (LVEF). Sustained VT: Defined as VT lasting longer than 30 seconds or requiring termination earlier due to hemodynamic collapse [4…

…elevated left ventricular (LV) filling pressures, defined invasively as a pulmonary capillary wedge pressure (PCWP) ≥15 mmHg at rest or ≥25 mmHg during exercise [4…

…Left to right shunt. Right ventricular dysfunction due to pressure/volume overload is the most common cause. Ebstein's anomaly The prevalence of Ebstein's…

…is sought on the dorsum of the foot lateral to the extensor hallucis longus tendon. Measure in the same way as on the arm. 4…

…lesions (these give a more superficial and less controllable depth of freeze). A size 15 scalpel or a pumice stone to pare down hyperkeratotic lesions…

…emergency. Infection can progress rapidly, while the typical local signs of inflammation may be faint or absent. Take cultures immediately, but never let sampling, imaging…

…a par with the degree of left ventricular impairment. Pathophysiology of takotsubo cardiomyopathy (broken heart syndrome) This topic is still under investigation. A number of…

…ECG 2 . Spontaneous termination of ventricular tachycardia (VT). ECG 3 . A single ventricular beat, followed by a three ventricular beats (VT). ECG 4 . Regular supraventricular…

…survival is 3 years. Long term prognosis in aortiv stenosis is presented in Figure 3. Figure 3. Prognosis in aortic stenosis according to type of…

…A convenient, bedside, clinical score for risk assessment at presentation: An intravenous nPA for treatment of infarcting myocardium early II trial substudy. Circulation. 2000 Oct…

…fibrillation (VF). ECG 4 . Polymorphic VT progresses to ventricular fibrillation (VF). ECG 5 . Ventricular fibrillation (VF). ECG 6 . Delivery of shock during ventricular fibrillation (VF).

…within than as figures to strive for. Ventilation In ARDS: a tidal volume of 4–8 mL/kg ideal body weight, a plateau pressure ≤ 30…

…m2 22 ± 6 29–33 34–39 40 22 ± 6 29–33 34–39 40 ​BSA, Body surface area; LA, left atrial; RA, right atrial.

…dysfunction) Reversible restrictive filling (grade 3 dysfunction) Irreversible restrictive filling (grade 4 dysfunction) E/A ratio 1–2 1–2 <1 1–1.5 (not…

Visual assessment of regional wall motion (left ventricle) TYPE OF MOTION DEFINITION WALL MOTION SCORE Normal Normal thickening (typically 30% thickening from end diastole to…

…above the goal despite statin and ezetimibe therapy. Goal: Achieve LDL C levels <1.4 mmol/L (55 mg/dL) to reduce cardiovascular risk. 1…

…the Society for Cardiovascular Magnetic Resonance. In Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography 30 (4), pp…

…the Society for Cardiovascular Magnetic Resonance. In Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography 30 (4), pp…

…and are related to atherosclerotic disease. At least 90% of AAAs larger than 4 cm are associated with atherosclerotic pathology. AAA prevalence increases with age…

…generally tolerate ischaemia for approximately 4–6 hours, making ALI a medical emergency in which prompt recognition, specialist assessment and restoration of perfusion are essential…

…approximately 4 days after infarction and is usually transient. Late post acute myocardial infarction pericarditis , traditionally termed Dressler syndrome , which is a manifestation of post…

…cardiac arrests, the survival rate stands at 73% (Podsiadlo et al.). A significant majority of these patients exhibit satisfactory neurological function upon discharge. Figure 1…

…are supraventricular beats during sinus rhythm. A brief run of polymorphic ventricular tachycardia (VT) occurs after the 4th beat. The VT terminates spontaneously after a…

…2 . VT progressing to ventricular fibrillation. ECG 3 . Ventricular fibrillation, coarse (large amplitudes). ECG 4 . Ventricular fibrillation. ECG 5 . Ventricular fibrillation, fine (low amplitudes). ECG…

…ECG 3 . Ventricular fibrillation (VF). ECG 4 . Ventricular fibrillation (VF). ECG 5 . Ventricular fibrillation (VF). ECG 6 . Delivery of shock, followed by asystole. ECG 7…

…of the ventricular tachycardia. ECG 4 . Recurrence and spontaneous termination of ventricular tachycardia. ECG 5 . Polymorphic ventricular tachycardia, self terminating. ECG 6 . Repeated runs of…

…within 10 minutes. 3. Attach defibrillator pads if the patient is unstable or at marked risk of arrhythmia. 4. Take a full blood count, electrolytes…

…Key messages Two things set the COPD exacerbation apart from many other causes of acute dyspnoea: oxygen must be titrated cautiously and the blood gas…

…unexplained AKI. 3. Assess the circulation and volume status, including signs of both hypovolaemia and venous congestion. 4. Take an urgent panel: creatinine, urea, sodium…

…access, but do not let blood sampling or cannulation delay inhaled treatment. 8. Reassess speech, work of breathing, level of consciousness and air entry repeatedly…

…2. Establish the time of symptom onset or the time last known to be well. 3. Assess airway, breathing and circulation. 4. Measure the plasma…

…or probable allergen , even if skin symptoms are absent [1,4]. Typical warning symptoms are: hoarseness, stridor, swelling of the tongue or throat dyspnoea, hypoxia…

…alternative treatment In aminoglycoside treatment of obese patients, an adjusted body weight is used: adjusted weight = ideal weight + 0.4 x (actual weight minus…

…why mixed acid base disorders are missed. The blood gas describes the physiology at the moment of sampling, but does not by itself identify the…

…3.9–5.3 cm 4.2–5.8 cm Wall thickness (septum, posterior wall) ≤ 0.9 cm ≤ 1.0 cm Left atrial volume index …

…Comment : : : Fasting plasma glucose 4.0–6.0 mmol/L ≥ 7.0 on two occasions establishes a diagnosis of diabetes HbA1c < 42 mmol/mol…

…hours Prednisolone 5 mg Moderate Intermediate, 12–36 hours Methylprednisolone 4 mg Low Intermediate Betamethasone 0.6 mg None Long, 36–54 hours Dexamethasone 0…

…often missed. On medical and geriatric wards a substantial proportion of older patients are affected, and the incidence is particularly high after hip fracture, major…