…symptoms An inadequate supply of glucose to the brain can cause: difficulty concentrating irritability or abnormal behaviour slurred speech visual disturbance confusion focal neurological signs…

…of myocardial infarction The Fourth Universal Definition separates MI into five principal types. Type Mechanism or setting Type 1 Acute atherothrombotic MI, usually related to…

…Contusio cordis Contusio cordis refers to a contusion of the myocardium, greater vessels or valves, due to a direct, non penetrating traumatic blow to the…

…Impending muscle fatigue Respiratory rate above 25 to 30 per minute Increased risk of ventilatory failure New drowsiness, confusion or agitation Suspect hypoxaemia or hypercapnia…

…trial shortens the time on the ventilator. See the article on confusion for the management of delirium in intensive care. Renal replacement therapy Absolute indications:…

…DW, Wickman LL, Swart GL. The hemodynamic and arterial blood gas response to asphyxiation: a canine model of pulseless electrical activity. Resuscitation 1995;30:16975…

…before a blood count is available. The nadir often occurs 7 to 14 days after a course of chemotherapy, but the timing varies considerably between…

…balanced crystalloid in the first instance. Give small boluses, for example 250 to 500 mL, with immediate reassessment of the blood pressure, pulse, peripheral perfusion…

…benefit of its administration in these patients should be carefully balanced against the potential risks resulting from hypotension. • Withdrawal of clonidine may lead to rebound…

…two papers and the authors of this article decided to adopt the criteria from MacFarlane et al . However, the confusion actually extends beyond the ECG…

…before starting treatment. Clinical assessment History that affects the level of risk Ask briefly and to the point: When did the deterioration begin, suddenly or…

…imbalance Hypercalcemia Definition : P/S Ca 2+ 2.6 mmol/L In approximately 90% of cases, hypercalcemia is attributed to primary hyperparathyroidism or neoplastic etiologies…

…lead to confusion between LBBB and acute STEMI. In fact, studies have shown that LBBB is the most common cause of false activations of the…

…with advancing age. Presentations without pain may include: Sudden breathlessness Syncope or sudden loss of consciousness Confusion Profound weakness An arrhythmia Peripheral embolism An ot

…the oral daily dose during the days of illness (the patient's sick day rules) Vomiting or diarrhoea, unable to keep tablets down Parenteral hydrocortisone…

…instability and hypertension [4]. Step 2: look systematically for acute organ damage Organ or condition Findings to look for Initial investigation : : : CNS Confusion, reduced consciousness…

…with a chronic plasma sodium of 112 mmol/L may be relatively unaffected, while a rapid fall from 140 to 125 mmol/L can cause…

…mortality, but most of the evidence was observational and the results must not be taken to mean that an electronic alert replaces clinical judgement [5]…

…Differentiating Pathologies : Helps differentiate cardiac vs. non cardiac causes of symptoms like dyspnea or failure to thrive. Limitations and Considerations Technical Challenges : Poor acoustic windows…

…exposure Concussion, temporal bone injury, dissection, aminoglycoside toxicity, antiepileptic drugs, alcohol or sedatives Trauma and medication directed workup This corresponds to the principles of TiTrATE…