…poisoning, withdrawal or several factors Inattention is central. A simple check is to ask the patient to recite the months of the year backwards. A…

…or treatment with another adenosine diphosphate (ADP) receptor inhibitor for patients who had coronary syndrome and are at high risk of developing a new event…

…the discomfort of angina pectoris but typically occurs at rest, is more severe, and lasts longer. The pain usually involves the central portion of the…

…Type B disease may produce rupture, renal, mesenteric or limb malperfusion, spinal cord ischaemia, paraplegia or paraparesis, rapid aortic expansion, refractory pain and hypertension despite…

…syndrome or symptomatic bradycardia in the absence of a pacemaker. Hypersensitivity to adenosine. Administration Normal route : Peripheral intravenous (IV). Alternative route : Central venous administration of…

…Aspiration Chronic obstructive pulmonary disease (COPD) Bronchospasm (asthma) Other : Coma Central hypoventilation syndromes Neuromuscular diseases Anemia The natural course of asphyxia Should ventilation be entirely…

…is continuous core temperature measurement and the active prevention of fever — defined as a temperature above about 37.7–37.8 °C — for at least…

…disorientation, agitation, drowsiness or a reduced GCS Respiration A respiratory rate of at least 22/min, increased work of breathing, a new oxygen requirement, a…

…be cold, pale, cyanotic or mottled. Capillary refill is delayed, and venous filling may be reduced. Other possible findings include muscle stiffening and loss of…

…repolarization and provoke ventricular tachycardia or ventricular fibrillation. The likelihood of clinically significant EMI is generally low, particularly with bipolar electrocautery performed away from the…

…dialysis catheter, not an ordinary triple lumen catheter). Measurement of central venous pressure and central venous oxygen saturation. Repeated blood sampling during intensive care. Exhausted…

…pathophysiology Congestion is a central expression of the heart failure syndrome and reflects excessive retention of sodium and water, with expansion of both the intravascular…

…and pathophysiology Lipid lowering therapy is a central component of cardiovascular prevention, particularly in patients with established atherosclerotic cardiovascular disease (ASCVD), chronic coronary syndrome (CCS)…

…a strong predictor of adverse outcomes. Table 1. Borg Rating of Perceived Exertion Scale RATING LEVEL OF EXERTION COMMENT 6 No exertion at all 7…

…20% of atrial size 4 10 cm² or 20 40% of atrial size 10 cm² or 40% of atrial size Jet orientation central variable excentric…

…obstruction of pulmonary blood flow increases RV pressure load and may impair RV filling and forward output. The resulting syndrome may progress to systemic congestion…

…and progression of atherosclerotic disease in patients with established coronary or other atherosclerotic vascular disease. Antiplatelet therapy is a central component because platelet activation and…

…with functional assessment. A central practical principle is that the visual severity of a stenosis does not reliably establish its haemodynamic importance. A lesion that…

…combined use of aspirin and an oral P2Y12 receptor inhibitor. It is central to the prevention of platelet mediated coronary thrombosis after acute coronary syndrome …

…increasing intensity may reduce overuse injuries. The practical principle is to begin at a low level and progress slowly. Exercise Intensity Intensity may be prescribed…

…and permanent—and is not determined solely by the apparent frequency or duration of documented episodes. The central therapeutic objective is prevention of thromboembolic complications…

…not apply. Assess gait and truncal stability and investigate for a central cause. Acute vestibular syndrome is often caused by acute unilateral vestibulopathy, commonly called…

…Marked cervical restriction of movement or pain — use the Semont manoeuvre or the side lying variant of the Dix–Hallpike test. Marked obesity or spinal…

…a central venous catheter and an arterial line is necessary to achieve an optimal result. Overview of vasopressors and inotropes Vasoconstriction Vasodilatation Positive inotropy Phenylephrine…

…at the same time [1]. Activate the local major haemorrhage protocol early. Protocols improve above all the logistics, the communication and the simultaneous delivery of…

…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…

…hemodynamic monitoring with ECG, central vein catheter and intra arterial catheter (A line) is warranted. Overview of vasopressors and inotropes Inotropes and vasopressors. Table 1…

…= (CO × SVR) + Central Venous Pressure (CVP) This equation illustrates that MAP is determined by the volume of blood the heart pumps and the resistance…

…infarction Pharmacology & dosing Definition and therapeutic objectives Antianginal therapy in chronic coronary syndrome (CCS) is directed primarily at reducing myocardial ischaemia and relieving anginal symptoms…

…CTI) at the inferior boundary, and ascends in a caudocranial direction along the interatrial septum. The left atrium is activated passively. The upper boundary of…

…Considerations The central pathophysiological concern in the emergency department is myocardial ischaemia caused by an acute coronary process. Myocardial injury leads to release of cardiac…

…characterized by persistently elevated plasma low density lipoprotein cholesterol (LDL C) from early life and a consequent excess risk of premature atherosclerotic cardiovascular disease (ASCVD)…

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

…symptoms are severe, refractory to guideline directed medical therapy, occur at a low level of exertion, or are associated with high event risk. The apparent…

…neurological manifestations of preeclampsia and the potential for stroke even at blood pressure levels that might otherwise be considered only moderately elevated. The syndrome can…

… and A thiazide or thiazide like diuretic, with all agents prescribed at maximum or maximally tolerated doses. The apparently uncontrolled office blood pressure must be…

…pressures are reduced. The central management principle is preservation of adequate right ventricular preload while supporting left ventricular performance and systemic circulation. Improvement in left…

…phase of the action potential. This action potential prolongation exhibits reverse use dependence, meaning the repolarization time is extended to a greater degree at slower…

…for the selected treatment to restore flow. Early reperfusion is therefore the central priority of STEMI systems of care. Fibrinolysis promotes thrombus dissolution by converting…

…defibrillation capability and expedited reperfusion central to survival. Clinical Presentation and Symptoms The characteristic symptom prompting activation of the STEMI pathway is ischaemic type chest…

…but redistribution of blood volume and increased ventricular contractility occur consistently. Exaggerated activation of a central reflex produces a stereotypic response: an initial increase in…

…rapidity of onset, is of paramount importance. The primary concern in correcting hyponatremia is the prevention of osmotic demyelination syndrome (ODS), previously known as central…

…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…

…times the energy consumption at rest (sitting). METs may be used to describe the functional capacity during exercise stress testing. Results of treadmill tests are…

…laminar flow , which implies that the flow velocity is highest at the center of the cylinder and the lowest along the cylinder walls. The liquid…

…hemodynamic monitoring with ECG, central vein catheter and intra arterial catheter (A line) is warranted. Overview of vasopressors and inotropes Inotropes and vasopressors. Table 1…

…PiCCO, central venous catheter). The hemodynamic effects persist for 7–10 days after the end of infusion. Refer to Table 2 for a comparison between…

…Biological death usually occurs within minutes thereafter; survival is highly unlikely after 8–10 minutes of no flow (i.e. cardiac arrest without any circulation)…

…at the same time as carbohydrate administration. 3. Rapid identification of seizures, delirium tremens, infection, trauma and metabolic disturbance. 4. Monitoring at the appropriate level…

…a small amount of lidocaine without adrenaline (epinephrine). 3. Puncture 1–2 cm proximal to the wrist crease at an angle of 30–45 degrees…

…why mixed acid base disorders are missed. The blood gas describes the physiology at the moment of sampling, but does not by itself identify the…

…kg over 20–60 min Central access for a longer infusion Metoprolol 5 mg IV, repeated to a maximum of 15 mg 0.1 mg…

…indexed Aortic annulus 20 31 mm 12 14 mm/m2 Sinuses of Valsalva 29 45 mm 15 20 mm/m2 Sinotubular junction 22 36 mm…

…Severe At least 6.5 mmol/L, or hyperkalaemic ECG changes at any level Immediate emergency treatment, continuous ECG monitoring and early assessment of the…

…or intensive care 3 Take at least two sets of blood cultures from separate peripheral punctures. Also culture from a central line if one is…

…where hypovolaemia is likely, but avoid repeated blind boluses in cardiogenic toxic shock D Plasma glucose immediately. Assess the level of consciousness, the pupils, tone…

…pads would go. Transvenous pacing: the relative contraindications are the same as for a central venous catheter — coagulopathy, infection at the puncture site, known thrombosis…

…early diastolic early diastolic holodiastolic Quantification of regurgitant jet Mild regurgitation Moderate regurgitation Severe regurgitation Jet width / LVOT width < 0,25 0,25 0…

…a central vein, the initial dose should be reduced. Dosage and Dose Escalation To terminate tachycardia, adenosine is rapidly injected intravenously at initial doses of…

…The back and arm should be supported, with the cuff at heart level. A standard cuff measuring approximately 12–13 cm in width and 35…