…but the sum of all contractions results in a reduction of the diameter and length of the ventricle by 20%, and more than 60% of…

…ventricle with varying orientation. This organization allows the left ventricle to contract in a highly sophisticated and effective way (Figure 1). Myocardial fibers adjacent to…

…anticholinergics, opioids and salicylate — where gastric emptying is delayed — may justify charcoal later, in some cases up to 6 hours or more. Discuss this with…

…well delivered supportive treatment matters more than the antidote [1,2]. Telephone your national or regional poison control centre , which in most countries is staffed…

…measuring more than 10 mm at end diastole after AMI should prompt investigation for possible subacute cardiac rupture, particularly when the effusion develops in the…

…fibrillation, and cardioversion of fibrillation of unknown duration without anticoagulation can cause a stroke hours to weeks later. Everything else in the procedure is routine…

…between blood and myocardium in terms of the reflected ultrasound waves. (1) The velocity of myocardial motion is significantly lower than the velocity of blood…

…diagnosis. With a longer expected delay and a symptom duration of less than 12 hours, immediate fibrinolysis is recommended in the absence of contraindications, followed…

…Take cultures immediately, but never let sampling, imaging, the blood count or contact with the patient's own clinic delay empirical antibiotics [1]. A practical…

…infarction. IIa B Routine blood sampling for serum markers is indicated as soon as possible in the acute phase but should not delay reperfusion treatment…

…count, electrolytes, creatinine, coagulation tests and troponin are taken in parallel but must not delay treatment in a patient without suspected coagulopathy or anticoagulant trea

…hallucinations More easily detected, but accounts for a minority of cases Hypoactive Lethargy, slow responses, reduced speech, immobility, poor food intake, reduced eye contact Common…

…give systemic antibiotics and contact an ophthalmologist urgently . A positive Seidel's sign. A foreign body centrally in the visual axis requiring an operating microscope…

…without the classical ECG findings. A rapidly rising potassium is usually more dangerous than a corresponding stable chronic value [4]. The grading must not be…

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

…contact with the blood bank. 3. Secure large bore access, or rapid central access, but do not delay transfusion or control of the bleeding in…

…below the ear. 4. Insert the catheter tip no more than 0.5 cm into the ear canal, not beyond the hair bearing skin. 5…

…that the patient gets too little oxygen but that the prescription has no target — the nasal cannula stays in place for days without anyone asking…

…so because the patient tenses up with pain, or because the operator pulls harder rather than more slowly. The neurovascular status must be documented before…

…volume increases by less than 0.025 L during the last second , or when the expiratory time has reached 15 seconds. In 2019 ATS/ERS…

…In placebo controlled trials, respiratory depression was no more common — and sometimes less common — after a benzodiazepine than with continued untreated status [3,4]. In…

…charged form in the tubular fluid, where they cannot be reabsorbed. The treatment looks simple — bicarbonate and a look at the urine dipstick — but it…

…reduce urethral trauma. The balloon is filled with sterile water according to the volume printed on the catheter , usually 10 mL in adults. Do not…

…main principle behind artificial pacemakers; i.e applying an external electrical current that depolarizes cells in contact with the lead tip, and thus generate an…

…a postrenal cause cannot confidently be excluded. 10. Contact nephrology early in severe, progressive or diagnostically unclear AKI. Definition and staging according to KDIGO Acute…

…itching without compromise of the airway, breathing or circulation is usually an allergic reaction but not in itself anaphylaxis. The patient must nonetheless be observed…

…Failing to ask when the last dose was taken. It matters more than the laboratory value. A normal INR and a normal APTT do not…

…g/L — a more liberal strategy gives worse outcomes A restrictive strategy is at least equivalent to a liberal one in virtually every group studied…

…interchangeable nozzles, or a cryoprobe for contact technique. Cotton buds for small lesions (these give a more superficial and less controllable depth of freeze). A…

…The donation process begins long before any retrieval: it begins when someone in the intensive care unit identifies a possible donor and the deceased person…

…output, respiration, chest findings, MAP and the response to every intervention Within 60 min Contact intensive care in shock, rapidly progressive organ dysfunction, respiratory failure…

…Haematochezia can occur in massive upper bleeding with rapid intestinal transit. Coffee ground vomiting is less specific than fresh haematemesis and can also be seen…

…instability. Posterior infarction may occur in patients with a clinically unstable acute coronary syndrome, but the examination does not reliably establish or exclude the diagnosis…

…Figure 3. Failure to capture. The pacemaker paces in the atrium but P waves are not visible, suggesting that the atria are not depolarized. Figure…

…Refrain from using activated charcoal if more than one hour has elapsed post ingestion unless the ingested substance has the propensity to form bezoars or…

…because less air filled lung tissue covers the heart. In adults, however, the distance between the heart and the transducer is greater and more lung…

…sodium and glucose loss in approximately a 1:1 stoichiometric relationship. The resulting glucosuria and natriuresis reduce proximal tubular workload, contract plasma volume and modestly…

…the ventricular myocardium to contract simultaneously. Since the membrane potential is relatively unchanged during the plateau phase, the potential differences in the myocardium will be…

…by a repolarization (recovery). The action potential occurs in all cardiac cells but its appearance varies depending on cell type. During de and repolarization ions…

…well with the severity and extent of ischemia. In the setting of moderate ischemia, the myocardium becomes hypokinetic, meaning that the ischemic segments contract less

…despite difficulties in visualizing it. Previously, the PA catheter ( Pulmonary Artery Catheter , also called Swan Ganz catheter ) has been the first choice, but today the…