…severity of the symptoms and the patient's need for help matter more than a single measured value [2]. Level Plasma glucose Meaning : : : Level 1…

…4. Monitoring at the appropriate level of care , with readiness for respiratory support. 5. Treatment of the alcohol use disorder and planned follow up , not…

…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…

…fenestrated drape. Chlorhexidine in alcohol 5 mg/mL. Local anaesthesia: lidocaine 10 mg/mL, 10–20 mL, a 25 G needle for the skin weal…

…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…

…and level of care. This quick reference is intended primarily for adults and summarises the order in which measures are taken and the principles that…

…bacterial CNS infections states that CT must not be performed before lumbar puncture in suspected bacterial meningitis — not even with a reduced level of consciousness…

…potentially life threatening causes of chest pain: Ischemic heart disease : stable angina pectoris, unstable angina pectoris, acute myocardial infarction (AMI). Note that unstable angina pectoris…

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

…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…

…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…

…blood loss or large volume shifts. Patients in whom non invasive measurement is unreliable: marked obesity, pronounced vasoconstriction, arrhythmia, intra aortic balloon pump. Assessment of…

…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…

…cannula, that determines how quickly the volume reaches the patient. Preparation and equipment Cannulae in several sizes, a tourniquet, chlorhexidine in alcohol 5 mg/mL…

…of 3, 5 and 10 mL, artery forceps, gauze, a dressing, gloves. A cold spray or a lidocaine weal. Site Triamcinolone hexacetonide 20 mg/mL…

…remnant that exhibits uniquely low flow velocities during the loss of organized atrial systole. Transesophageal echocardiography and surgical pathology demonstrate that over 90% of thrombi…

…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…

…mg/mL, 5–10 mL, 25 G for the skin wheal and 21 G for the deeper layers. Diagnostic tap: 21–22 G needle, 20…

…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…

…and alkalaemia , which describe the current pH of the blood. Acidosis and alkalosis , which describe processes that lower and raise pH respectively. A patient may…

…by home measurement or 24 hour recording — the thresholds for which are lower than for office measurement. Classification of office blood pressure Category Systolic Diastolic : : : : :…

…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

…cardiovascular benefits of blood pressure lowering among the frailer participants enrolled in trials. In contrast, observational studies have sometimes suggested that lower blood pressure may…

…20 daytime and 7 night time values, and with a measurement interval of no more than 30 minutes throughout the 24 hours. Phenotype Office blood…

…of headache, palpitations, sweating and pallor that may suggest phaeochromocytoma. Systemic sclerosis, kidney disease, autoimmune disease or previous thrombotic microangiopathy. Antidepressants can affect the blood…

…s exertion rating provides an estimate of the actual heart rate. For example, if the perceived exertion is 12, then 12 x 10 = 120…

…equally compromised, leading to uniform perfusion that may appear deceptively normal on SPECT. Detecting multivessel disease requires quantification of absolute coronary blood flow. This is…

…viability of compromised myocardial tissue, aiding revascularization decisions when the potential benefits are uncertain. Myocardial perfusion imaging is based on the principle that myocardial blood…

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…

…in advanced cases, loss of consciousness. Focal neurological findings are uncommon in hypertensive encephalopathy and should prompt consideration of stroke. Acute ischemic or intracerebral haemorrhage…

…or renal disease The possibility of a secondary cause The medical and medication histories should specifically assess drugs or substances that may increase blood pressure…

…marker of perfusion Lactate < 1.6 mmol/L Clearance over time is more informative than a single value Urine output 0.5 mL/kg…

…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…

…cardiac arrest, as evidenced by the fact that only 0.5% of all hangings exhibit VF on the initial ECG recording ( Kitamura et al, Deasy…

…and direction of blood flow. This is possible because sound waves that hit moving objects are reflected at an altered frequency. Sound waves that hit…

Procedurer The value of the exercise test lies not in ST depression alone but in the overall picture : exercise capacity, symptoms, blood pressure response, heart…

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

…then activates calcium sensitive potassium channels in the cell membrane. Time to onset of action : 1 minute. Duration of action : <10 minutes. Effects Potent blood…

…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…

…substantial morbidity and mortality, despite often having a greater burden of cardiovascular and non cardiovascular comorbidity than patients with reduced EF. Pathophysiology Abnormal ventricular relaxation…

…particles. Increased apoB containing particles and remnants may provide a more accurate assessment of atherogenic burden than LDL cholesterol alone in patients with diabetes. Insulin…

…blood pressure despite multidrug treatment rather than through specific symptoms. The clinical importance lies in its association with: Increased cardiovascular disease risk; Greater risk of…

…or foam cells, and a thin fibrous cap. Disruption of the cap exposes the lipid core and extracellular matrix to circulating blood. Tissue factor within…

…the frequency of ultrasound waves that are reflected back to the transducer. There are two fundamental differences between blood and myocardium in terms of the…

…Document the ceiling of care and the decision on intubation early. Initial assessment Confirm that the presentation fits an exacerbation A COPD exacerbation is an…

…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…

…of: age ≥ 80 years, weight ≤ 60 kg, creatinine ≥ 133 µmol/L Rivaroxaban 20 mg × 1 15 mg × 1 at an eGFR of 15–49 mL…

…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…

…requirement. Obstetric haemorrhage of around 1,500 mL or more with continuing bleeding, or a smaller measured blood loss if there is physiological compromise. Do…

…ABCDE, full vital signs, level of consciousness, and repeated assessment of the circulation and breathing 2 Assess whether the patient has sepsis, septic shock, or…

…The shunt fraction (Qp/Qs) is a critical hemodynamic parameter used to quantify the ratio of pulmonary blood flow (Qp) to systemic blood flow (Qs)…

…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…

…Time to onset of action 1 minute Duration of action 20 30 minutes Delivery IV Dose Loading dose: 500 μg/kg bolus over 1…

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

…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…