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…

…important indication and an emergency procedure . An unclear arthritis, as part of the diagnostic work up. Haemarthrosis after trauma. A symptomatic effusion causing pain or…

…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…

…the right ventricle rises, which results in right ventricular hypertrophy. The valve is usually thickened and during systole leaflet doming appears. The proximal part of…

…at paper speed 50 mm/s. Figure 4. RBBB and LBBB. Electrophysiology of right bundle branch block (RBBB) Under normal conditions, both ventricles depolarize simultaneously…

…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…

…myocardial segmentation for echocardiography and cardiac imaging Cardiovascular imaging modalities have developed rapidly in the past few decades. The repertoire of available methods includes echocardiography…

Cardiology Introduction Since its initial description in 1992 as a syndrome of right bundle branch block, ST segment elevation, and sudden cardiac death (SCD), Brugada…

…bundles of myocytes that form the slow conducting isthmuses critical for re entry [6] . Non ischemic dilated cardiomyopathy (NICM), hypertrophic cardiomyopathy (HCM), and arrhythmogenic right…

…demonstrate that while the incidence of HFrEF has stabilized or slightly declined over the past two decades, the incidence of HFpEF continues to rise steeply…

…BSA. Basal segments of the right ventricle (i.e parts on the atrial side of the tricuspid annulus) function as atrium and becomes dilated. The…

…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…

…in the past three weeks, even before a blood count is available. The nadir often occurs 7 to 14 days after a course of chemotherapy…

…out of 100 cases had full recovery. More recent studies has reported mortality rates reaching 4%. ECG in takotsubo cardiomyopathy (broken heart syndrome) 80% 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…

…<10%) 3 Dyskinesia Paradoxical thinning and/or outward directed motion during systole 4 Aneurysmatic Diastolic deformation 5 Recommended by the American Society for Echocardiography (J…

…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…

…1 cm² ZTime velocity integral of the tricuspid inflow (cm) 60 cm Pressure half time (T ½,ms) ≥ 190 ms Right atrium Severly enlarged Vena…

…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…

…In patients with pericarditis complicated by constriction, symptoms and signs of right sided heart failure may predominate. Pericardial effusions associated with post infarction pericarditis are…

…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…

…oedema and mucus plugging. Expiratory flow limitation causes air trapping and dynamic hyperinflation. The consequences are increased work of breathing, exhaustion and, in the most…

…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…

…E/e′ (mean) < 14 < 14 Aortic valve area 3.0–4.0 cm² 3.0–4.0 cm² Grading of aortic stenosis: mild…

…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…