…occurs after an abrupt reduction or cessation of prolonged and heavy alcohol intake. The condition can develop despite a measurable or high blood alcohol concentration…

…a marked risk of aspiration, or failure that is not rapidly reversed by an antidote B Respiratory rate, saturation, chest movement and a blood gas…

…curved array or linear probe. Sterile clothing: gown, gloves, cap, mask, fenestrated drape. Chlorhexidine in alcohol 5 mg/mL. Local anaesthesia: lidocaine 10 mg/mL…

…determinants of cardiovascular disease. The principal targets include blood pressure, lipid abnormalities, diabetes and glycaemic status, body weight, smoking, diet, physical inactivity, and alcohol consumption…

…can swallow safely. 4. Give intravenous glucose if the patient has a reduced level of consciousness, is having seizures or cannot swallow. 5. If there…

…for the assessment of pH and bicarbonate. An arterial blood gas is needed mainly when concomitant respiratory failure or an exact assessment of oxygenation requires…

…a reduced level of consciousness, focal neurological signs or seizures — because the delay costs more than the scan contributes. Only clinical signs of herniation halt…

…related to body position or respiration. Triggering factors Symptoms triggered by exercise/effort (what level of exercise)? Symptoms at rest? Symptoms more easily provoked after…

…of cardiovascular disease increases gradually at blood pressure levels above 115/75 mm Hg. • A rise in blood pressure of 20 mm Hg systolic or…

…drinks for women or five for men on one occasion. Pharmacokinetics and pathophysiology Approximately 95% of ingested ethanol undergoes hepatic metabolism. Alcohol dehydrogenase converts ethanol…

…Dose Injection IV: • 150 μg in 1 ml vial. Dilute with 10 ml of normal saline and give by slow injection over 5 10…

…there is a risk of blood contact. An alcohol or chlorhexidine swab. Let the skin dry completely before inserting the needle — alcohol carried in with…

…cap. Lidocaine 10 mg/mL for local anaesthesia in the awake patient — the anaesthetic also improves the chance of success by counteracting vascular spasm. Pressure…

…consent, current full blood count and coagulation screen, medication list. Chlorhexidine in alcohol, sterile gloves, fenestrated drape, sterile gauze. Local anaesthetic: lidocaine 10 mg/mL…

…probe, a sterile probe cover and sterile gel. Chlorhexidine in alcohol 5 mg/mL for skin disinfection. Allow it to air dry completely before puncture…

…equipment Chlorhexidine in alcohol 5 mg/mL: clean with 3–4 swabs in wide circles and let it dry for a couple of minutes before…

…Continuous ECG, blood pressure and saturation monitoring; a defibrillator to hand. Sterile gown and gloves, chlorhexidine in alcohol 5 mg/mL, a large fenestrated drape…

…reaches the patient. Preparation and equipment Cannulae in several sizes, a tourniquet, chlorhexidine in alcohol 5 mg/mL, gauze, a transparent dressing, an extension set…

…hexacetonide (Lederspan 20 mg/mL) or methylprednisolone acetate (Depo Medrol 40 mg/mL). Triamcinolone acetonide (Kenacort T) has been out of stock for a long…

…Elderly age ( 65), and Drugs/alcohol. A crucial clinical pitfall is the misapplication of this score. A high HAS BLED score (≥3) indicates a need…

…aminoglycoside toxicity, antiepileptic drugs, alcohol or sedatives Trauma and medication directed workup This corresponds to the principles of TiTrATE, in which Timing, Triggers And Targeted…

…alcohol 5 mg/mL), sterile gloves, fenestrated drape; full sterile attire for therapeutic drainage with an indwelling catheter. Lidocaine 10 mg/mL, 5–10 mL…

…of drinking quality tap water or sodium chloride 9 mg/mL. The volume matters more than the fluid; irrigate under pressure through a 20 mL…

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

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

…A transfusion set with a filter. Blood components must not be given through a set without a filter. Sodium chloride 9 mg/mL for flushing

…or limited life expectancy. Available randomized evidence has not demonstrated that frailty weakens the cardiovascular benefits of blood pressure lowering among the frailer participants enrolled…

…and with a measurement interval of no more than 30 minutes throughout the 24 hours. Phenotype Office blood pressure ABPM : : : Normotension Normal Normal White coat…

…rise in blood pressure from a previously low level can cause organ damage at lower values, for example in pregnancy, acute glomerular disease or scleroderma…

…a fairly good estimate of the actual workload. The perceived exertion may be graded from 0 (none) to 10 (maximal exertion) or according to the…

…levels of redistribution can move from areas of higher concentration to regions with lower concentration, for reasons other than perfusion differences, making image interpretation more…

…Reference values for coronary blood flow Normal coronary blood flow at rest: 0.6 to 1.3 mL/min/g of myocardial tissue During hyperemia…

…disappearance of Korotkoff sounds; if sounds persist, the fourth Korotkoff sound is used. Office blood pressure: blood pressure measured in a clinical setting, manually or…

…without clinical evidence of acute, ongoing target organ damage. Although BP reduction is required, these patients generally do not need hospital admission or intravenous treatment…

…observed treatment or detection of prescribed medications in blood or urine samples. In patients with an estimated glomerular filtration rate below 30 mL/min/1…

…leg raising with an increase in stroke volume 10%, or inferior vena cava variability . In the absence of responsiveness, fluid does more harm than good.

…blood regurgitates back from the aorta into the left ventricle. This results in volume overload in the left ventricle during diastole. The hemodynamic consequences of…

…of hypoxic cardiac arrest : Trauma and injuries : Direct trauma can cause airway injuries, resulting in obstruction. Central nervous system (CNS) injuries might cause apnea or…

…Only a brief summary of the Doppler effect is provided here. The Doppler effect is used to assess the velocity and direction of blood flow…

…with a braked, workload controlled resistance; 12 lead ECG with continuous recording; automated or manual blood pressure measurement. Resuscitation trolley with defibrillator, oxygen, suction and…

…5 min to desired blood pressure. Maximum dose: 100 μg/min. Time to onset of action: 2 to 5 minutes Duration of action: 5…

…perfusion. • Dose dependent elevation of intracranial pressure (ICP) and reduction in cerebral blood flow. Caution • Used cautiously in patients with high intracranial pressure or azotemia…

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

…the heart cannot provide blood flow commensurate with the body’s requirements, or can do so only at the expense of abnormally high filling pressures…

…blood at a rate appropriate to tissue requirements unless filling pressures are elevated. The syndrome is therefore defined by symptoms and signs of congestion or…

…abdominal, or visceral, adipose tissue is more closely related to insulin resistance and the risk of diabetes and cardiovascular disease than total adiposity alone. The…

…treatment or detection of prescribed drugs in blood or urine. The terms “controlled resistant hypertension,” referring to blood pressure controlled with four or more medications…

…conceptual framework Acute coronary occlusion is the abrupt or progressive reduction of coronary blood flow sufficient to produce myocardial ischaemia and, when prolonged or severe…

…of blood flow. However, the Doppler effect can also be used to study myocardial motion. Myocardial motion during systole and diastole alter the frequency of…

…risk of hypercapnia has been assessed. 3. Take an arterial blood gas in respiratory compromise, low saturation, suspected carbon dioxide retention, reduced consciousness, or when…

…aphasia, hemianopia or hand paresis in a person of working age Blood pressure Measure initially in both arms if this does not delay reperfusion treatment…

…eGFR of 15–49 mL/min Edoxaban 60 mg × 1 30 mg × 1 at an eGFR of 15–50 mL/min, weight ≤ 60 kg, or…

…Condition Overall strategy Common first choices : : : Acute aortic syndrome Immediate rate control and rapid reduction of the systolic blood pressure towards 100 to 120 mmHg…

…or haematochezia, or a continuing rapid transfusion requirement. Obstetric haemorrhage of around 1,500 mL or more with continuing bleeding, or a smaller measured blood…

…the blood count or contact with the patient's own clinic delay empirical antibiotics [1]. A practical target: give the first dose of broad spectrum…

…quantify the ratio of pulmonary blood flow (Qp) to systemic blood flow (Qs). This measurement is pivotal in diagnosing and managing congenital or acquired cardiac…

…metabolite (ester) of enalapril, an angiotensin converting enzyme (ACE) inhibitor. Enalaprilat lowers blood pressure by inhibiting ACE. Effects • The hypotensive effect of enalaprilat depends on…

…to reduce myocardial ischemia in the CCU or ICU. Time to onset of action 1 minute Duration of action 20 30 minutes Delivery IV Dose…

…Short term management of hypertension, including hypertensive emergency. Mechanism of action • Systemic Dopamine 1 (D1) receptor agonist. • Lowers blood pressure while maintaining or increasing kidney…

…reduces blood pressure without affecting cardiac filling pressures. • Clevidipine is more effective than nitroglycerin, nitroprusside, and nicardipine in hypertensive emergencies. Time to onset of action…