…begins in parallel with the diagnostic work up. Obtain an interpretable 12 lead ECG within 10 minutes of first medical contact, attach continuous rhythm monitoring…

…possible due to the small distance between the heart and the ultrasound transducer, and because less air filled lung tissue covers the heart. In adults…

…oxygen requirement, a saturation below 93 per cent on air, or a falling PaO2 Circulation A systolic blood pressure of 100 mmHg or less, a…

…abdominal or thoracic surgery 1 month Neurosurgery or an intracranial aneurysm Contact the responsible specialist An aortic aneurysm 6 cm Relative — avoid forced manoeuvres An…

…Give a full loading dose of an intravenous antiseizure drug If the seizure continues after adequate step 1 and step 2 Refractory status: contact anaesthesia…

…intestinal transit. Coffee ground vomiting is less specific than fresh haematemesis and can also be seen when the bleeding is slow or has stopped. The…

…a straddle injury Relative Recent urethral or prostatic surgery — contact a urologist before attempting Relative A known urethral stricture Relative Acute prostatitis or urethritis Relative…

…with the electronics in the pulse generator or dislodgement or fracture of the leads. External causes are less common and include electrolyte disorders, metabolic disorders…

…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…

…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…