…reduced level of consciousness Coma Marked drowsiness, for example a Glasgow Coma Scale below 8 Vomiting together with clear neurological impairment Respiratory failure or respiratory…

…Measure the plasma glucose immediately in everyone with a reduced level of consciousness, seizures, confusion, a change in behaviour, collapse or an acute neurological deficit…

…or system Finding : : CNS New confusion, disorientation, agitation, drowsiness or a reduced GCS Respiration A respiratory rate of at least 22/min, increased work of…

…in: a reduced level of consciousness with inadequate protective reflexes active major haematemesis severe agitation respiratory failure an anticipated difficult or prolonged endoscopic intervention a…

…people with diabetes and becomes more common with advancing age. Presentations without pain may include: Sudden breathlessness Syncope or sudden loss of consciousness Confusion Profound…

…raised blood pressure together with ongoing or new organ damage in which immediate, controlled blood pressure lowering can limit the damage. The choice of drug…

…anxious Confusion, reduced consciousness or marked stillness Respiratory rate Under 25 per minute At least 25 per minute A falling rate, bradypnoea or apnoea Pulse…

…or fall in cTn with at least one value above the 99th percentile URL; and Clinical evidence of acute myocardial ischaemia , demonstrated by at least…

…standard CPR, as per guidelines). Contusio cordis Contusio cordis refers to a contusion of the myocardium, greater vessels or valves, due to a direct, non…

…renal insufficiency, therapeutic interventions with tamoxifen or lithium, thiazide administration, and over supplementation of calcium and vitamin D. ECG in hypercalcemia Typical ECG changes: Shortened…

…A patient with BPPV is usually relatively free of symptoms between the brief attacks. Lying down, turning over in bed or looking up triggers a…

…muscles or paradoxical abdominal breathing Impending muscle fatigue Respiratory rate above 25 to 30 per minute Increased risk of ventilatory failure New drowsiness, confusion or…

…treated with CAR T cells or other advanced immunotherapies may require separate local protocols. Definition Criterion Practical definition : : Fever A single temperature of at least…

…g in 1 ml vial. Dilute with 10 ml of normal saline and give by slow injection over 5 10 minutes. Dilute immediately before use…

…confusion, convulsion, tachycardia, hypotension, coma. As above but with lower temperatures. Electrolyte replacement. Large infusions of fluids are typically needed. Table 1. Grading of hyperthermia…

…T changes. Such ST T changes may mimic (simulate) or mask ischemia. Simulation of ischemia manifests as ST segment elevations in leads V1–V3, accompanied…

…or about suppression of the HPA axis, where a long half life produces more marked suppression. Stress dosing in known adrenal insufficiency A patient with…

…heparin unless contraindicated Head of the bed 30–45° Stress ulcer prophylaxis During mechanical ventilation, in coagulopathy, or with a history of gastrointestinal bleeding Refeeding…

…ventricular fibrillation. The combination of early repolarization pattern on ECG and ventricular fibrillation or sudden cardiac arrest is referred to as early repolarization syndrome . Early…

…1, not 200%). Conclusion Echocardiographic calculation of Qp/Qs is a cornerstone in managing patients with intracardiac shunts. By integrating anatomical measurements and Doppler hemodynamics…