…of myocardium at risk. Over 48 hours: urgent PCI is still indicated with continuing ischaemia, shock, serious arrhythmia or acute heart failure. Routine opening of…

…the decision on intubation early. Initial assessment Confirm that the presentation fits an exacerbation A COPD exacerbation is an acute or subacute worsening of dyspnoea…

…nephrology early in severe, progressive or diagnostically unclear AKI. Definition and staging according to KDIGO Acute kidney injury is present when at least one of…

…in hypoxaemia, repeated doses of an inhaled short acting β2 agonist, ipratropium in more severe attacks, and a systemic steroid given early [2,3]. Grading…

…suggest aortic dissection CT of the brain Exclude intracerebral haemorrhage and assess early ischaemic changes CT angiography The standard investigation in acute stroke to identify…

…is: Continuous acute dizziness with spontaneous nystagmus: consider HINTS plus, but only if the examiner is trained. Brief attacks triggered by the position of the…

…saccular aneurysm. Symptomatic isolated lesions may represent early periulcer haemorrhage or developing IMH and carry greater risk of progression or rupture than asymptomatic lesions. Predisposing…

…Types 2–5 MI have other mechanisms of myocardial ischaemia and necrosis. Unstable angina (UA) represents myocardial ischaemia without demonstrable acute cardiomyocyte injury or necrosis…

Clinical medicine Emergency medicine Definition and pathophysiology Acute limb ischaemia (ALI) is an abrupt reduction in arterial perfusion of an upper or lower limb that…

…of monitoring, supportive treatment, anticoagulation, and possible reperfusion. The principal pathophysiological determinant of early adverse outcome is acute RV failure. In acute PE, obstruction of…