…and the superior gluteal artery are avoided. The patient lies on their side with the knee slightly flexed. Place the palm on the greater trochanter…

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

…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…

…1.73 m², excess urinary albumin excretion—typically a spot urinary albumin to creatinine ratio (UACR) above 30 mg/g—or both. The eGFR is…

…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…

…in renal failure and in old age Amiodarone In severe haemodynamic compromise where the above cannot be used It also has a rhythm control effect…

…physical activity and any other precipitating factor. Thresholds The thresholds below are used above all in diabetes. The severity of the symptoms and the patient…

…< 20 kPa (150 mmHg), and permissive hypercapnia as long as the pH stays above about 7.20. Different targets apply when the intracranial pressure…

…obesity or a stiff chest wall. Glottic or subglottic obstruction — the mask sits above the obstruction and solves nothing. A mouth opening below about 2…

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

…1]. Activate the local major haemorrhage protocol early. Protocols improve above all the logistics, the communication and the simultaneous delivery of red cells, plasma and…

…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…

…hypovolaemia, requires a vasopressor to maintain a MAP of at least 65 mmHg and at the same time has a lactate above 2 mmol/L…

…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 measurement and the active prevention of fever — defined as a temperature above about 37.7–37.8 °C — for at least 72 hours in…

…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…

…RVOT DIAMETER Above aortic valve (RVOT 1), cm 2.5–2.9 3.0–3.2 3.3–3.5 3.6 Above pulmonic valve…

…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…

…myocardial injury, defined by an elevated cardiac troponin (cTn) value with at least one value above the 99th percentile upper reference limit (URL). The injury…

…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;…

…international guidance. One framework defines confirmed hypertension as blood pressure consistently above 130/80 mmHg on more than two measurements obtained at separate times, whereas…

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

…Indications PCSK9 inhibitors are used as additional lipid lowering therapy in patients whose LDL C remains above the recommended goal despite maximally tolerated statin therapy…

…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…

…90 mmHg, respectively, despite: Appropriate lifestyle measures; A renin–angiotensin system blocker; A calcium channel blocker; and A thiazide or thiazide like diuretic, with all…

…is measured in at least two leads. Areas above the baseline (typically the TP segment) are assigned positive polarity, while areas below the baseline are…

…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…

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

…a dose of 30 ml/kg. Should fluid resuscitation fail to maintain a mean arterial pressure (MAP) above 65 mmHg, consider the initiation of vasopressor…

…confusion, convulsion, tachycardia, hypotension, coma. As above but with lower temperatures. Electrolyte replacement. Large infusions of fluids are typically needed. Table 1. Grading of hyperthermia…

…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…

…using pulsed wave Doppler. Generally, velocities above 1.5 m/s to 1.7 m/s cannot be measured correctly. Figure 1. The difference between…

…seconds). The QRS complex is wide simply because the ectopic impulses that cause these rhythms spread partially or entirely outside of the ventricular conduction system…

…accessory respiratory muscles or paradoxical abdominal breathing Impending muscle fatigue Respiratory rate above 25 to 30 per minute Increased risk of ventilatory failure New drowsiness…

…about 2 cm above the tip of the malleolus. 3. Dorsalis pedis artery — the signal is sought on the dorsum of the foot lateral to…

…Measure the waist between the lowest rib and the iliac crest, at the end of expiration, with the tape horizontal and without compressing the skin…

…0.5 mg/L FEU Age adjusted threshold: age × 0.01 above 50 years INR 0.9–1.2 APTT 28–40 s Fibrinogen 2…

…according to the guideline Hyperglycaemia Glucose measurement, above all in the afternoon and evening. See the quick reference on inpatient insulin therapy Peptic ulcer A…

…with poor circulation, above all the lower leg in a patient with peripheral arterial disease or diabetes — the wound may not heal. Over superficial nerves…

…The condition occurs above all in: treatment with SGLT2 inhibitors pregnancy prolonged fasting or a very low carbohydrate intake excessive alcohol consumption vomiting or othe

…region. Duration above the threshold or unknown: at least three weeks of adequate anticoagulation before cardioversion — an INR ≥ 2.0 checked weekly on warfarin, 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…

…a system System Flow Approximate FiO2 Comment : : : : Nasal cannula 1–6 L/min 24–44 % Comfortable; the patient can eat and talk. Flows above 6…

…between regions. Common practice is correction at an INR above 1.5 and a platelet count below 50 × 10⁹/L before drain insertion, while diagnostic…

…1 % suggests a prerenal cause, above 2 % acute tubular necrosis — but the value is unreliable during diuretic therapy, where a fractional excretion of urea below…

…serum concentration. Alkalinisation increases renal elimination several fold and at the same time reduces the passage of salicylate into the central nervous system. Contact your…

…ventricular tachycardia. Brugada's algorithm for differentiating ventricular tachycardia from antidromic AVRT The algorithm above frequently fails to differentiate ventricular tachycardia from antidromic AVRT. Although…

…the balance of risk and benefit determine whether treatment is initiated. High 3 9 As above. Very high Oral anticoagulation (warfarin or NOAC) is recommended…

…troponin attributable to myocardial ischaemia. UA presents with compatible ischaemic symptoms but without cardiac specific troponin elevation above the 99th percentile. The clinical presentation should…