…from apical windows. The patient's left arm should be placed under the patient's head. This stretches in the chest wall, such that the…

…tightened the former 48 hour rule for patients with risk factors. Check what applies in your own region. The time limit is not a guarantee…

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

…3 or higher indicates high risk of major bleeding Note that a high HAS BLED score should not be used as a reason to withhold…

…agents Platelet transfusion has weak evidence; discuss with the on call coagulation service Always in parallel: mechanical control of bleeding, tranexamic acid where it is…

…already bleeding costs precious time. Exact validity periods and the rules for electronic issue differ between regions — follow the local transfusion medicine regulations. In life…

…for sedation, analgesia and control of shivering. Procedure 1. Start temperature management early — within the first hour after ROSC, in parallel with coronary angiography, the…

…minute) • Esmolol may also be used to control supraventricular tachycardia (rate control). • Esmolol may be used to reduce myocardial ischemia in the CCU or ICU…

…a vasopressor and early source control. Sepsis is a dynamic condition. Investigation and treatment must therefore proceed in parallel and must not wait for complete…

…Pulmonary hypertension. Blood pressure control. Mechanism of action Nitroglycerin provides nitric oxide (NO) that induces vasodilatation (of both arterioles and veins) via generation of cyclic…

…• Should not be given to pregnant women. • Should not be given to patients with Leber optic atrophy. Nitroprusside doses and administration in hypertension (hypertensive crisis…

…used. The number of prescribed tablets is directly related to adherence, and simplifying the regimen may improve persistence and control. Medication should be taken a

…reader will notice that most of these drugs are contraindicated in patients with structural heart disease, as well as patients with reduced left ventricular function…

…the pretreatment inadequate and the cardioversion must be postponed. Alternative when more rapid cardioversion is needed: transoesophageal echocardiography (TOE) excluding thrombus in the left atr

…risk of rebound. The referring physician should have made this decision; document which applies. Nitroglycerin is continued; note it in the report. Shaving and careful…

…delayed — may justify charcoal later, in some cases up to 6 hours or more. Discuss this with the poison control centre. Gastric lavage is considered…

…without basal insulin (a so called sliding scale), gives poorer control and is not recommended as the sole regimen. Common situations Situation Management : : Fasting before…

…the lung injury. Discuss with your national or regional poison control centre. An open flame or smoking in the room: a fire hazard. Preparation and…

…national or regional poison control centre , which in most countries is staffed around the clock for health care professionals. Contact the centre early in serious…

…regional poison control centre in poisoning before treatment is started. They give current advice on the treatment threshold, sampling intervals and when dialysis should be…

…CCB therapy. Nicorandil and trimetazidine are additional options in selected patients. Treatment choices should be integrated with management of precipitating factors such as anaemia, uncontrolled…

Cardiology Myocardial ischemia and infarction Definition and pathophysiology Atherosclerosis is a chronic, inflammatory disease of the arterial wall in which lipid accumulation, vascular cell dysfunction…

…beyond glycaemic control. Proposed mechanisms include: Reduction in glomerular hypertension and hyperfiltration Decreased tubular energy demand and oxygen consumption Natriuresis and diuresis Reduction in plasma…

…Glycaemic control is important for prevention of microvascular complications, but intensive glucose lowering alone has shown little or no consistent effect on cardiovascular complications in…

…One should always suspect digoxin as the trigger of an arrhythmia (in patients using digoxin) if there is evidence of increased automaticity and diminished impulse…

…rhythm monitoring Indications Palpitations, presyncope or syncope of suspected arrhythmic origin. Assessment of rate control in atrial fibrillation. Suspected paroxysmal atrial fibrillation, including after cryptogenic…

…tazobactam 4 g × 3 IV 4 days if source control has been achieved, 7 days in bacteraemia or cefotaxime plus metronidazole 1 g × 3 IV…

…dilution instructions and the local protocol before prescribing. Basic principles of treatment The patient should be managed in an emergency department, an intensive care unit…

…Use of intravenous rhythm control antiarrhythmics (class I and class III) within 4 hours prior to, as well as in the first 4 hours after…

…even in patients with left ventricular dysfunction, though those with depressed ejection fraction should receive it with great caution due to the risk of hypotension…

…Term Strategies The initial approach to bradycardia management involves identifying and treating any underlying conditions or reversible causes. The first step in treating sinus bradycardia…

…events per 1000 patient years, compared with 15.0 per 1000 patient years in age matched controls without autoimmune disease. The greatest risks were reported…

…randomized trials in people with established coronary disease found fewer cardiovascular events with Mediterranean dietary interventions than with low fat control diets. In one trial…

…Its primary clinical utility in contemporary practice is late line therapy for patients who remain profoundly symptomatic despite optimal neurohormonal blockade and adequate volume control…

…despite control Hypertension with spontaneous or diuretic induced hypokalaemia Hypertension with an adrenal incidentaloma Hypertension associated with sleep apnoea Hypertension with atrial fibrillation in the…

…control, on the other hand, attempts to restore sinus rhythm by use of antiarrhythmic drugs. Randomized controlled trials have not demonstrated any clear difference in…

…poison control centre, and activate the emergency medical response system using your local emergency number. Contact the nearest intensive care unit with expertise in toxicological…

…may be caused by myocardial ischemia. Other symptoms include dyspnea, pain radiating to the left arm/shoulder/throat, palpitations, back pain and selected cases of…

…If rate control is inadequate, the use of Class IA, IC, or III antiarrhythmic agents may be considered. Catheter ablation should be considered in patients…

…Gain control regulates the global (overall) gain . Increasing the overall gain will increase the gain for all reflected sound waves, making all objects in the…

…on manufacturer and user settings) circle next to the transducer; this is the side indicator that assists the examiner to identify left and right in