…A central line set with a triple lumen catheter, usually 7 Fr. Catheter length: the right internal jugular vein requires the shortest catheter, while left…

…FASS) before administration — concentrations and formulations differ between units, and most serious dosing errors arise at the dilution step, not in the choice of dose…

…or other atherosclerotic vascular disease. Antiplatelet therapy is a central component because platelet activation and aggregation contribute importantly to arterial thrombus formation, recurrent coronary occlusion…

…centre , which in most countries is staffed around the clock for health care professionals. Contact the centre early in serious, unusual or unclear poisoning, with…

…the cause, and assess the risk for future episodes and serious harm. This evaluation should include a detailed history, thorough questioning of eyewitnesses, and a…

…discussed in this article. Metabolic equivalent (MET): measuring oxygen consumption Estimation of oxygen consumption is central to the assessment of exercise capacity. Metabolic equivalents (METs…

…monitoring and early assessment of the need for dialysis ECG changes or serious neuromuscular symptoms mean a high risk even if the plasma potassium is…

Cardiology Pharmacology & dosing Definition and pathophysiology Congestion is a central expression of the heart failure syndrome and reflects excessive retention of sodium and water, with…

Cardiology Pharmacology & dosing Definition and pathophysiology Lipid lowering therapy is a central component of cardiovascular prevention, particularly in patients with established atherosclerotic cardiovascular disease (ASCVD…

…Exercise stress test Evaluation of the exercise stress test (exercise ECG) The ECG reaction has always been a central component of the exercise stress test…

…of atrial size 10 cm² or 40% of atrial size Jet orientation central variable excentric Pulmonary vein flow S dominant reduced S wave systolic flow…

…clinical severity, evidence of right ventricular (RV) dysfunction, and myocardial injury. This classification is central to determining the intensity of monitoring, supportive treatment, anticoagulation, 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…

…receptor inhibitor. It is central to the prevention of platelet mediated coronary thrombosis after acute coronary syndrome (ACS) and percutaneous coronary intervention (PCI). Aspirin irreversibly…

…undertaken to maintain or improve physical fitness. Regular physical activity is a central component of cardiovascular prevention and treatment. It is associated with lower cardiovascular…

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

…resulting in obstruction. Central nervous system (CNS) injuries might cause apnea or hypoventilation. Respiratory conditions : Tension pneumothorax Drowning Airway obstruction Hanging Pneumonia High altitude sickness…

…disturbance without nystagmus: HINTS does not apply. Assess gait and truncal stability and investigate for a central cause. Acute vestibular syndrome is often caused by…

…Sit the patient up again and observe the eyes for a further period — reversal of the nystagmus is common. 6. Repeat on the left side…

…and haemodynamic monitoring with ECG, a central venous catheter and an arterial line is necessary to achieve an optimal result. Overview of vasopressors and inotropes…

…bore access, or rapid central access, but do not delay transfusion or control of the bleeding in order to obtain a central venous catheter. 4…

…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…

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

…as described by the relationship: MAP = (CO × SVR) + Central Venous Pressure (CVP) This equation illustrates that MAP is determined by the volume of blood…

…symptoms, while maintaining tolerability and adherence. Selection should be individualized according to blood pressure, heart rate, left ventricular function, comorbidities, concomitant medications, potential drug interactions…

…and ascends in a caudocranial direction along the interatrial septum. The left atrium is activated passively. The upper boundary of this circuit may be located…

…had an infarction. Pathophysiological Considerations The central pathophysiological concern in the emergency department is myocardial ischaemia caused by an acute coronary process. Myocardial injury leads…

…affecting approximately 1 in 250,000–350,000 individuals. The lifelong exposure to high LDL C is central to the disease burden. In untreated HeFH…

…ventricular relaxation and increased filling pressures The central hemodynamic abnormality in HFpEF is impaired diastolic function. The left ventricle may have apparently preserved global systolic…

…The pre test probability is central because the clinical value of any diagnostic test depends not only on its sensitivity and specificity but also on…

…and disturbed angiogenic signalling. A central biochemical feature is an imbalance between antiangiogenic and angiogenic factors. Placental production of soluble fms like tyrosine kinase 1…

…before resistant hypertension can be defined. The central physiological contributors include excess salt intake and salt and water retention, particularly when kidney function is impaired…

…Right sided filling pressures—including central venous, right atrial, and right ventricular end diastolic pressures—are elevated, whereas left ventricular filling pressure is usually normal…

…patients prior to sotalol initiation. Diagnostics Electrocardiography (ECG) Electrocardiographic monitoring is central to the safe initiation and maintenance of sotalol therapy. The drug prolongs the…

…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…

…making rapid recognition, defibrillation capability and expedited reperfusion central to survival. Clinical Presentation and Symptoms The characteristic symptom prompting activation of the STEMI pathway is…

…hyponatremia is the prevention of osmotic demyelination syndrome (ODS), previously known as central pontine myelinolysis. Excessively rapid correction of sodium can result in catastrophic demyelination…

…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…

…uses to calculate various hemodynamic parameters. The Doppler effect The central principle to all hemodynamic calculations is the Doppler effect, which was discussed previously (see…

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

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

…In stroke, neuronal cell death begins in the central ischemic zone, where the ischemia is most pronounced and extends towards the penumbra zone (the outermost…

…withdrawal. Benzodiazepines enhance the function of the GABA A receptor and are cross tolerant with alcohol. They therefore treat the central mechanism underlying withdrawal, unlike…

…in marked shock or during high dose vasopressor treatment, when the radial trace may underestimate central pressure. The dorsalis pedis artery works but often shows…

…sometimes supplemented with a central venous sample Common approximate arterial reference ranges in adults are: pH 7.35 to 7.45 pCO₂ 4.7 to…

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

…small variable large if central, variable if excentric Coaptation defect mild moderate severe CW profile aortic regurgitation weak variable dense Size left atrium normal normal…

…cultures from separate peripheral punctures. Also culture from a central line if one is present 4 Take a full blood count with a differential, CRP…

…MAP remains below 65 mmHg or the hypotension is marked. Do not wait for a central venous catheter Continuously Reassess the mental state, capillary refill…

…fan, paracetamol, cold infusions. A ventilator, an arterial line, a central venous catheter, ECG monitoring, blood gases. Drugs for sedation, analgesia and control of shivering…

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

…small variable large if central, variable if excentric Coaptation defect mild moderate severe CW profile aortic regurgitation weak variable dense Size left atrium normal normal…

…to 12 months. Use with caution in patients at risk for bradycardia (slow heart rate). Central sleep apnea, including Cheyne Stokes respiration, has been reported…

…distal to the suspected obstruction Arterial and venous Doppler signals Evidence of systemic disease or a potential embolic source Neurological assessment is central to triage…

…A flush should immediately follow the bolus injection to ensure rapid delivery to the central circulation. If the drug is injected into a central vein…

…be biased by the clinical environment. Out of office measurement is consequently central to diagnosis and long term management. Clinical presentation and symptoms The source…

…may produce cardiorenal syndrome. Worsening renal function in the presence of persistent congestion is particularly associated with elevated central venous pressure, which is transmitted to…

…2, and 3 MI, clinical evidence of acute myocardial ischaemia is central. Symptoms of myocardial ischaemia are a primary diagnostic criterion for acute MI. For…

…aorta. Type III: originates in the descending aorta, usually just distal to the left subclavian artery. Type IIIa: remains confined to the descending thoracic aorta…

…therapy, with or without other lipid lowering treatment. The durability of the response is central to its clinical use. After the initial treatment phase, administration…