… a higher threshold may be considered individually in ongoing ischaemia Upper gastrointestinal bleeding that has been stabilised 70 g/L — a more liberal strategy gives…

…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…

…used to assess the one year risk of major bleeding in patients with atrial fibrillation (AF) who are taking anticoagulants. It was developed in 2010…

…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…

…cannot be used It also has a rhythm control effect; plan as though cardioversion will occur Target rate in the acute phase: a resting ventricular…

…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…

…gain control , as discussed earlier. The gain must be calibrated, such that blood filled spaces (ventricular cavities, atrial cavities, vessels) should appear black in 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…

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

…treatment inertia, in which patients remain on an inadequate single drug regimen for prolonged periods. The evidence supports improved blood pressure control and adherence, although…

…and calcium channel blockers on rhythm, conduction and ECG waveforms Although the purpose of antiarrhythmic drugs is to control arrhythmias, these medications may also cause…

…atria begin to contract again. An unsynchronised shock that happens to fall in the T wave can precipitate ventricular fibrillation, and cardioversion of fibrillation of…

…assessment Hypertrophic cardiomyopathy with outflow tract obstruction Caution Tachyarrhythmia or bradyarrhythmia Rate control first Blood pressure 200/110 mmHg at rest Treat first Electrolyte disturbance…

…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…

…3. Correct the hypokalaemia. Aim for a serum potassium in the upper normal range, around 4.0–4.5 mmol/L, and continue replacement throughout…

…therapeutic aim is symptom control rather than modification of long term cardiovascular outcomes. With the important exception of beta blockers in selected patients after acute…

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…

…used in patients who do not achieve satisfactory effects using first line therapies. Digoxin is also used frequently in the emergency setting to control ventricular…

…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…

…rapid or precise control is required, for example in acute aortic syndrome, marked neurological organ damage, or treatment with sodium nitroprusside. In most hypertensive emergencies…

…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…

…left ventricular dP/dt. Oral doses sufficient to control arrhythmias do not depress left ventricular ejection fraction (LVEF), even in patients with reduced LVEF. However…

…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…

…also important to control the placement of electrodes. Incorrect placement of electrodes, or varying placement between repeated recordings, may cause significant variations in the ECG…

…is typically sufficient in patients whose atrial tachycardia is induced by the drug. Management of all other cases aligns with the approach used for atrial…

…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…

…The crystals are activated from one side to the other, as illustrated in Figure 2. The sequence of activation goes from right to left and…