…Septic phlebitis, ongoing soft tissue infection with systemic involvement. Relative: Condition Adaptation : : ABI 0.5–0.79 Reduced compression (20–30 mmHg) under vascular surgical…

…with a high BMI, and that the deltoid injection is placed too high — which causes the shoulder injury known as SIRVA. Both are avoided with…

…during titration: Give the injection slowly over at least a minute; a rapid injection causes nausea and a fall in blood pressure without better analgesia…

…with several simultaneous renal insults. Infection, hypovolaemia, cardiac dysfunction, haemodynamic instability, anaemia and other nephrotoxic exposures may contribute to tubular injury, making attribution to contrast…

Procedurer The single most important step in any eye injury is to measure and document the visual acuity before anything else is done. The second…

…of wound infection is retained contamination, not poor suture technique — and the commonest cause of permanent loss of function is a tendon injury that was…

…blood gas and electrolytes can be interpreted, but some laboratories do not accept marrow blood in their analysers — check locally. Contraindications Peripheral venous cannula: Infection…

…respiratory acidosis, or a markedly increased work of breathing with impending exhaustion. Threatened airway obstruction: inhalation injury, anaphylaxis, deep neck infection, an expanding haematoma, facial…

…and elevated CK. Rhabdomyolysis is a rare, severe form of muscle injury. The biological basis of many reported muscle symptoms remains uncertain. Randomized trials have…

…episodes Iatrogenic events (e.g., during central venous catheter insertion) Underlying lung pathologies In cases of benign pneumothorax, positive pressure ventilation can precipitate a tension…

…injuries, hemodynamic and respiratory instability, multiorgan failure, infections, seizures and temperature management. The ICU is the preferred level of care for the absolute majority. The…

…perspiration and exhaled breath. Blood alcohol concentration generally peaks 10–60 minutes after ingestion. Elimination follows zero order kinetics at low to moderate concentrations and…

…raised blood glucose for 2–5 days. Suspected or known tendon rupture. No response to previous injections at the same site. More than three injections…

…crisis. Mechanism of action Phentolamine is a non selective alpha adrenergic blocker. Phentolamine reduces blood pressure while increasing catecholamine activity. Effects Primarily causes afterload reduction…

…the plasma glucose, a blood gas and an ECG all come before complete identification of the substance. Treatment of acute poisoning consists of four parallel…

…the medulla result in the blood pressure lowering effect. Effects Potent blood pressure lowering effect. Pain relief. Delivery IV, IM, PO, transdermal Dose Injection IV: •…

…a sterile tube and blood culture bottles (aerobic and anaerobic) for culture, and a fluoride tube for glucose and lactate. For injection: the corticosteroid drawn…

…alternative premedication. Peripheral venous cannula, saline flush. ECG monitoring, pulse oximetry and blood pressure measurement throughout the test. Oxygen, suction, a bag and mask, and…

…Blood clearance is required because blood causes strong backscatter of the light signal. Imaging is therefore typically performed during contrast injection or another method of…

…Lathundar Key message Fever in a neutropenic patient is an emergency. Infection can progress rapidly, while the typical local signs of inflammation may be faint…

…COPD exacerbation apart from many other causes of acute dyspnoea: oxygen must be titrated cautiously and the blood gas determines the need for ventilatory support …

…cessation of prolonged and heavy alcohol intake. The condition can develop despite a measurable or high blood alcohol concentration, particularly in patients with marked tolerance…

…time windows, indications and contraindications for intravenous thrombolysis, weight based tenecteplase dosing, blood pressure thresholds, monitoring, complications and when thrombectomy should be considered. The doses…

…When pulsatile blood appears in the hub: lower the angle to close to the plane of the skin and advance a further 1–2 mm…

…involvement. Work up of unexplained iron, B12 or folate deficiency when blood tests are insufficient. Contraindications Severe coagulopathy or ongoing anticoagulation — correct this first . Thrombocytopenia…

Procedurer What determines the outcome of a central venous catheter insertion is decided before the needle goes in: the choice of site, the use of…

…Suspected subarachnoid haemorrhage with a normal or non diagnostic CT. Suspected neuroborreliosis, neurosyphilis or another CNS infection. Suspected inflammatory disease: multiple sclerosis, Guillain–Barré syndrome…

…Delivery IV or IM. Dose Injections • IV: 10–40 mg every 4–6 hours • IM: 10–20 mg every 4–6 hours. Infusion • Afterload reduction…

…and reduces myocardial oxygen consumption. Time to onset of action: 5 minutes. Effects Lowers blood pressure, reduces heart rate, myocardial oxygen consumption and myocardial contractility…

…Otherwise: Type Contraindication : : Absolute No safe pocket of fluid to puncture (no ultrasound verified fluid) Relative Uncorrected coagulopathy or thrombocytopenia Relative Ongoing anticoagulant treatment — plan…

…wait for complete diagnostic certainty. Sepsis is defined as life threatening organ dysfunction caused by a dysregulated host response to infection. Clinically this usually corresponds…

…own laboratory uses before applying it. The D dimer is raised in pregnancy, malignancy, infection, surgery, trauma and old age. A positive value is not…

…myocardial ischaemia or syncope — that has not responded to atropine: Complete heart block (third degree AV block) and second degree AV block Mobitz type 2…

…PAWP ≤15 mmHg, and PVR ≤2 Wood units may have increased pulmonary blood flow rather than pulmonary vascular disease. This state is termed unclassified PH…

…straightforward: ultrasound to find the fluid, an insertion site in the left lower quadrant lateral to the rectus sheath, and a cell count plus albumin…

…reduce this residual risk without necessarily altering lipid concentrations, blood pressure or other conventional risk factors. Colchicine is an established anti inflammatory drug that may…

…heart disease is a complication of rheumatic fever, which is caused by streptococcal infections (group A Streptococcus ). Rheumatic heart disease can occur at any age…

…ECG and clinical examination, blood tests and other radiological examinations are most often required, in particular computed tomography (DT) and/or magnetic resonance imaging (MRI…

…Monitoring with ECG, blood pressure and saturation throughout the investigation. Explain to the patient what is going to happen and that the most important thing…

… bilateral brachial blood pressure measurement; cardiac auscultation; inspection of the legs and feet. A systolic blood pressure difference between the arms exceeding 15 mmHg is…

…or valvular disease Recent (<48 hours) use of dipyridamole or dipyridamole containing medications Ingestion of caffeinated foods or beverages within 12 hours prior to testing

…weight, height, ECG, blood pressure, heart rate, ECG. References Narula et al: Time to Add a Fifth Pillar to Bedside Physical Examination: Inspection, Palpation, Percussion…

…expected range of compensation. Sample type and baseline values An arterial blood gas is the reference method when the question concerns oxygenation, precise ventilation or…

…Classification of office blood pressure Category Systolic Diastolic : : : : : Optimal < 120 and < 80 Normal 120–129 and/or 80–84 High normal 130–139…

…or pregnancy. Check the validity before ordering blood ; an expired type and screen discovered when the patient is already bleeding costs precious time. Exact validity…

Cardiology Clinical medicine Definition and Clinical Context Blood pressure management in older adults must account for chronological age, biological age, frailty, multimorbidity, cognitive status, functional…

…the circumference, do not guess. Measure the blood pressure in both arms when fitting the device. Use the arm with the higher pressure, or the…

…term hypertensive urgency is best avoided. It implies that an asymptomatic rise in blood pressure must be treated urgently, which is not supported by evidence…

…Exercise performance (functional capacity, exercise capacity) Heart rate: maximal heart rate, heart rate response Blood pressure reaction ECG reaction: ST changes, T wave changes, arrhythmias…

…uniform perfusion that may appear deceptively normal on SPECT. Detecting multivessel disease requires quantification of absolute coronary blood flow. This is possible using PET scanners…

…coronary artery disease (CAD). It offers visual and numerical insights into myocardial blood flow under rest and stress conditions. MPI uses radiotracers in combination with…

Cardiology Definition and pathophysiology Blood pressure is a continuous cardiovascular exposure rather than a binary distinction between normotension and hypertension. Its long term relationship with…

Cardiology Emergency medicine Definition and Pathophysiology A hypertensive emergency is severe blood pressure elevation accompanied by acute hypertension mediated target organ damage (HMOD). The European…

Cardiology Endocrinology & metabolism Definition and pathophysiology Secondary hypertension is elevated blood pressure attributable to a specific, identifiable underlying cause. It should be considered in every…

…Haemodynamic measurements become interpretable only when related to one another. A low blood pressure may be due to low flow, low vascular tone or both…

…that the aortic valve leaks during diastole, such that blood regurgitates back from the aorta into the left ventricle. This results in volume overload in…

CPR Hypoxia and asphyxiation Hypoxia refers to a reduced partial pressure of oxygen in the blood. Asphyxia is characterized by insufficient ventilation, leading to hypoxia…

…the Doppler effect is provided here. The Doppler effect is used to assess the velocity and direction of blood flow. This is possible because sound…

…cardiomyopathy with outflow tract obstruction Caution Tachyarrhythmia or bradyarrhythmia Rate control first Blood pressure 200/110 mmHg at rest Treat first Electrolyte disturbance Correct Second…

…nitroglycerin regularly may have developed tolerance and require higher doses, alternatively nitroprusside to achieve desirable blood pressure lowring effect. Drug Nitroglycerin Brand names Gonitro ®…