…see the table), a syringe of the correct size, a sharps bin. For vaccination: adrenaline 1 mg/mL, an antihistamine, oxygen, and the ability to…

…whereas bilevel NIV delivers pressure support above the expiratory pressure and thereby increases ventilation and lowers the carbon dioxide. Pulmonary oedema calls for the former…

…mm) to 100 ms. Intervals and durations QTc — decision thresholds At a QTc above 500 ms: stop QT prolonging drugs, correct the potassium to 4…

…not exclude dangerous hyperkalaemia. Record a 12 lead ECG and start cardiac monitoring at a plasma potassium above 6.0 mmol/L, and at lower…

…single blood pressure value does not define a hypertensive emergency. Even a blood pressure above 220/120 mmHg can occur without acute organ damage. Conversely…

…not met with statins alone. PCSK9 Inhibitors: Added in cases where LDL C remains above the goal despite statin and ezetimibe therapy. Goal: Achieve LDL…

…cholesterol (LDL C), particularly when statins cannot be tolerated or when LDL C remains above goal despite maximally tolerated therapy. It is a prodrug activated…

…pathophysiology Chronic kidney disease (CKD) is defined by abnormalities of renal structure or function that persist for more than 3 months and have health implications…

…Myocardial injury Myocardial injury is a biochemical diagnosis defined by at least one cardiac troponin value above the assay specific 99th percentile upper reference limit…

…V2–V3. The amplitude diminishes with increasing age. As noted above, the transition from the ST segment to the T wave should be smooth. The…

…of atrial fibrillation correlates strongly with age. Approximately 10% of individuals aged 80 years and above have atrial fibrillation, whereas the arrhythmia is unusual among…

…Management : : 50 Standard dose, creatinine checked at least annually 30 50 Dose reduction as in the table above for rivaroxaban and edoxaban. Check every 6…

…contraindicated, for example in asthma Contraindicated in impaired left ventricular function and together with an intravenous beta blocker Digoxin In heart failure or hypotension, or…

…The thresholds below are used above all in diabetes. The severity of the symptoms and the patient's need for help matter more than a…

…aims in themselves. Almost all of them have proved to work better as ranges to stay within than as figures to strive for. Ventilation In…

…need for high airway pressures, for example severe ARDS, marked obesity or a stiff chest wall. Glottic or subglottic obstruction — the mask sits above the…

…with post thrombotic syndrome. Differential diagnosis Feature Venous ulcer Arterial ulcer Diabetic foot ulcer : : : : Site Gaiter area, above the medial malleolus Toes, heel, lateral malleolus…

…Transfusion restores circulating volume, oxygen transport and haemostatic capacity, but it cannot compensate for an uncontrolled source of bleeding. Minimise the time to surgery, endoscopy…

…tachypnoea, cold periphery Almost always Pulsus paradoxus above 10 mmHg A fall in systolic blood pressure during inspiration; one of the most useful signs Low…

…time has a lactate above 2 mmol/L. This combination carries a high mortality [1,2]. Give antibiotics immediately and aim for administration within one…

…A morning value below about 100 nmol/L strongly suggests insufficiency, and a value above about 350–400 nmol/L makes it unlikely; in between…

…temperature above about 37.7–37.8 °C — for at least 72 hours in patients who remain unconscious. The evidence is insufficient to recommend for…

…18.5 Normal weight : 18.5 to 24.9 Overweight : 25 to 29.9 Obese : 30 and above Limitations of BMI Despite its widespread use…

…et al. (2003): Recommendations for evaluation of the severity of native valvular regurgitation with two dimensional and Doppler echocardiography. In Journal of the American Society…

…conventional hypertension threshold. The traditional diagnostic threshold of 140/90 mmHg derives from epidemiological observations associating pressures above this level with increased mortality. Contemporary management…

…fundamental prerequisite for diagnosing any MI is myocardial injury, defined by an elevated cardiac troponin (cTn) value with at least one value above the 99th…

…myocardial injury, demonstrated by a rising and/or falling troponin pattern with at least one value above the assay specific 99th percentile upper reference limit;…

…as blood pressure consistently above 130/80 mmHg on more than two measurements obtained at separate times, whereas European recommendations for initial combination therapy refer…

…women. For European populations, waist circumference above 94 cm in men or 80 cm in women is considered indicative of obesity or excess abdominal adiposity…

…activity therefore contributes to higher LDL C concentrations. The genetic evidence provides the rationale for therapeutic inhibition. Gain of function PCSK9 mutations are associated with…

…which are reciprocal to posterior Q waves. As mentioned above, posterior myocardial infarction may be accompanied by inferior infarction if the occlusion affects both vascular…

…as blood pressure above goal despite three or more antihypertensive drugs from different classes at maximally tolerated doses, including a diuretic appropriate for kidney function…

…progress [3]. The mean electrical axis is typically calculated for ventricular activation in the frontal plane using the hexaxial reference system. This system is constructed…

…injury. Myocardial injury Myocardial injury is defined by at least one cardiac troponin (cTn) concentration above the assay specific 99th percentile upper reference limit (URL)…

…table below shows a systematic history taking in patients presenting with chest pain (chest discomfort) or other symptoms suggestive of the five conditions listed above…

…dyspnea, chest discomfort, and anxiety. As the tachyarrhythmia originates above the ventricles, ventricular depolarization proceeds normally via the His Purkinje system, and in most cases…

…followed. Moreover, for optimal management in the context of sepsis induced cardiac arrest, consider the following recommendations: Administer 100% oxygen at the maximum flow rate …

…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…

…both cardiopulmonary function and alertness. Cardiac arrest is unlikely to occur when body temperature remains above 28° C (82.4° F), while temperatures below 24°…

…atrium. Recall that velocities (flows) directed away from the transducer are displayed below the baseline and velocities towards the transducer are displayed above the baseline…

…infants and during the childhood years. Below follows a discussion on each of the nine parameters listed above. Many of the diagnoses mentioned below are…

…such as in ischemia. In both cases listed above the impulse will originate in the junction between the atria and the ventricles, which is why…

…constant (1540 m/s), the PRF only depends on the distance the sound waves must travel. The longer the distance, the more time required for…

…1. Ventricular rhythm. One exception to the rule above should be noted. If an ectopic focus arises in or near the bundle of His, the…

…than mild. 6. Assess the indication for antibiotics on the basis of sputum purulence, the other cardinal symptoms and the severity of the illness. 7…

…Preparation: The patient must have rested lying down for at least 10 minutes in a room at a comfortable temperature — a cold foot gives falsely…

…0.9 kg per cm above 152 cm. Adjusted body weight: ideal weight + 0.4 × (actual weight − ideal weight). Used for aminoglycosides and when estimating…

…around 46 % that at least one will fall outside. The ranges below are guide values for adults. The method and the laboratory determine the range —…

…or an infusion Suspected adrenal crisis Give the corticosteroid immediately. Do not wait for laboratory results. Take a serum cortisol and ACTH first only if…

…cold alone. The temperature at the outer edge of the tissue is decisive: benign tissue requires about −25 °C for reliable cell death, malignant tissue…

…has high diagnostic accuracy [2]. A venous blood gas is generally sufficient for the assessment of pH and bicarbonate. An arterial blood gas is needed…

…is then reserved for patients with a CHA₂DS₂ VA score of 0–1. Check what applies in your own region. Duration above the threshold or…

…SGLT2 inhibitors and sulfonylureas. Basal insulin often reduced Corticosteroid treatment This causes marked hyperglycaemia above all in the afternoon and evening. Increase the mealtime insulin…

…be prescribed as one: with an indication, a route of administration and a target range for the saturation . What usually goes wrong is not that…

…radiology department The thresholds for the INR and the platelet count vary between regions. Common practice is correction at an INR above 1.5 and…

…reduced G5 < 15 Kidney failure Albuminuria Albuminuria is an independent risk marker for both kidney failure and cardiovascular death — a patient with an eGFR…

…arterial pH above 7.55 already before starting. Severe hypernatraemia. Preparation and equipment Two peripheral venous cannulas, or a central venous catheter for longer treatment…

…specificity (60–90%) for diagnosing ventricular tachycardia. Brugada's algorithm for differentiating ventricular tachycardia from antidromic AVRT The algorithm above frequently fails to differentiate ventricular…

…High 3 9 As above. Very high Oral anticoagulation (warfarin or NOAC) is recommended for all female patients with a score of 3 or more…

…increasing frequency, duration, or severity; a lower threshold for symptom provocation; or angina occurring after a recent MI. Myocardial injury is separate from MI. It…