…artery. According to current guidelines, laypeople do not need to perform the 3 rd assessment (reliable assessment of pulses requires training and experience). Thus, for…

…is the first line treatment and must be given early when anaphylaxis is suspected. Do not wait for a complete diagnosis or for grading. Antihistamines…

…CPR should not be started. Moreover, CPR should not be started if it is evident that survival is impossible. The term do not attempt CPR…

…of all myocardial infarctions and episodes of myocardial ischemia, do not cause ventricular arrhythmias and cardiac arrest. It is clear that only a negligible fraction…

…3,4]. In parallel with the drug treatment Resuscitation, investigation and drug treatment must proceed simultaneously. Do not wait for laboratory results, CT or EEG…

Procedurer Aspirate and biopsy answer different questions and do not replace one another: the aspirate shows cellular morphology and provides material for flow cytometry and…

…not with force. The methods that work best exploit time, gravity and slow movement; those that fail usually do so because the patient tenses up…

…blood gas and electrolytes can be interpreted, but some laboratories do not accept marrow blood in their analysers — check locally. Contraindications Peripheral venous cannula: Infection…

…do nothing else. The two ways in which casting harms the patient are that it is too tight — the swelling comes after the injury, not…

…aside time, coach actively, and do not accept a trace you would not be prepared to show a colleague. Indications Investigation of chronic cough, dyspnoea…

…cerebrovascular diseases, such as: Transient ischemic attacks (TIA). Stroke Contraindications Cross reactivity: Do not administer to patients with a history of asthma, rhinitis, or urticaria…

…means that the pacemaker stimulations do not result in myocardial activation. Failure to pace (FTP) , which means that the pacemaker does not stimulate as expected…

…heart failure, despite their negative chronotropic effect. Among persons who do not suffer from heart failure, chronotropic incompetence may be caused by beta blockers, amiodarone…

…However, current guidelines do not consider this fact (beyond the recommendation to defibrillate immediately if cardiac arrest is witnessed and the rhythm is shockable). This…

…patient groups and care settings [2]. Practical first actions Do the following in parallel, not sequentially: 1. Check previous creatinine values and establish the time…

…contamination, not poor suture technique — and the commonest cause of permanent loss of function is a tendon injury that was sutured over without being found…

…commensurate with the body’s requirements, or can do so only at the expense of abnormally high filling pressures. The resulting haemodynamic congestion produces a…

…narrow overestimates the pressure. Measure the circumference, do not guess. Measure the blood pressure in both arms when fitting the device. Use the arm with…

…Confirm the potassium with a repeat sample, but do not delay treatment when there are ECG changes, circulatory compromise or a very strong clinical suspicion…

…assessment [1]. Treat immediately when there are symptoms and a low glucose. Do not wait for the venous laboratory result. 1. Assess and stabilise the…

…5. With severe symptoms: give hypertonic saline immediately. Do not wait for a complete work up of the cause or for imaging. 6. Document the…

…Non specific ST depressions, T wave inversions (negative T waves) do not affect the management of cardiac arrest. Recurrent VT or VF after ROSC in…

…However, there are situations with transmural ischemia that do not yield ST elevations. It is important to recognize these situations since they should be managed…

…the same time, exacerbation is a clinical syndromic diagnosis, not a sufficient explanation for all acute dyspnoea in a patient with COPD. Pneumonia, heart failure…

…to as atrial rhythm . Cells near the atrioventricular node: The atrioventricular node does not possess automaticity, but cells surrounding it do. These cells are capable…

…based on symptoms, the ECG and haemodynamics. Do not wait for troponin. If clinical suspicion persists despite an initially non diagnostic ECG, the ECG must…

…a systemic steroid early. 7. Insert intravenous access, but do not let blood sampling or cannulation delay inhaled treatment. 8. Reassess speech, work of breathing…

…160 mg twice daily 160 mg twice daily 100 mg twice daily Do not use Trimethoprim sulfamethoxazole 160/800 mg twice daily 160/800 mg…

…the corticosteroid immediately. Do not wait for laboratory results. Take a serum cortisol and ACTH first only if this does not delay treatment. Plus fluid…

…first line treatment and must be given before anything else. An antihistamine and a corticosteroid do not affect the acute course. Measure Adult Child : : : Adrenaline…

…or cannot reach it with the instruments available. Do not then try "by feel" — refer to ENT. Relative — a low threshold for referral: Marked swelling…

…skin. 2. Clean and let it dry. Do not palpate the puncture site again with an unsterile hand. 3. Insert the needle in one movement…

…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…

…selected cases the patient can be observed without anticoagulation Red flags and pitfalls A normal saturation and a normal ECG do not exclude pulmonary embolism…

…MAP remains below 65 mmHg or the hypotension is marked. Do not wait for a central venous catheter Continuously Reassess the mental state, capillary refill…

…year. The Achilles tendon and the patellar tendon — do not inject into or beside them. Anticoagulant treatment is not a contraindication to these superficial injections…

…thereby decreasing the likelihood of arrhythmia onset. However, beta blockers do not fully eliminate the risk. In LQT3 patients, where arrhythmias often occur at rest…

…thereby decreasing the likelihood of arrhythmia onset. However, beta blockers do not completely eliminate the risk. In LQT3 patients, where arrhythmias often occur at rest…

…empty stomach may provide the fastest onset of effect. Do not crush or split the tablet . Warnings and Precautions Bleeding Risk In the phase 3…

…is low, renal excretion is negligible, and doses do not require reduction in patients with renal disease; neither amiodarone nor desethylamiodarone is dialyzable. The volume…

…aged 40–69 years SCORE2 is recommended for adults aged 40–69 years with elevated BP who do not already have increased cardiovascular risk beca

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…similar. Unfortunately, these ECGs do not show any sign of early repolarization. Note that this paper has been cited almost 500 times since publication. It…

…target organ damage. Although BP reduction is required, these patients generally do not need hospital admission or intravenous treatment. Some patients with acute pain, anxiety…

…part of shared clinical decision making. Pathophysiological and Diagnostic Considerations Angiographic severity and physiological severity do not always correspond. Visual estimation of luminal narrowing may…

…express proteins detected by some troponin T assays. Troponin can enter the circulation through mechanisms that do not necessarily involve established pathological necrosis. Brief ischaemia…

…also protect against future proximal disease progression, while stents do not prevent the development of new proximal atherosclerosis. The choice between procedures therefore depends on…

…A sense of impending doom When STEMI begins during exertion, the symptoms generally do not resolve simply with cessation of activity, unlike typical exertional angina…

…CAD), in non obstructive coronary arteries, or in patients with intermediate lesions that do not produce physiologically significant flow limitation. The mechanisms are incompletely defined…

…Non ST Elevation Myocardial Infarction). Patients with NSTE ACS who do not develop infarction are classified as unstable angina (UA), which is an imminent precursor…

…are based on conventional 12 lead ECG. Established ECG criteria do not apply to mathematicallyderived 12 lead ECGs (e.g EASI, Frank's leads etc)…

…However, digoxin is still used in patients who do not achieve satisfactory effects using first line therapies. Digoxin is also used frequently in the emergency…

…changes. Specific electrolyte disorders 1. Sodium Increased (hypernatremia) and decreased (hyponatremia) sodium levels do not have any effect on the ECG, nor cardiac rhythm, or…

…depolarization (i.e they display automaticity) and can therefore act as latent pacemakers (which become active when atrial impulses do not reach the atrioventricular node)…

…pronounced than those caused by ischemia. As a result, the ischemic changes are obscured and do not become apparent. However, there are exceptions to this…

…for pathological R wave progression is considerably lower than pathological Q waves and guidelines do not state any ECG criteria specific to R wave progression…

…sound waves travel through time and space, the particles of the medium do not travel with the sound wave. The particles merely vibrate and transmit…

…atrial ( retrograde direction ) or both. Accessory pathways do not display the slow conduction that the atrioventricular node does, and this means that any impulse reaching…

…elevations in ischemia are dynamic. A patient may initially present with ST segment elevations that do not fulfill the ECG criteria, only to develop magnificent…

…ventricular function — e.g ejection fraction (EF), fractional sorting (FS), etc — do not elucidate regional variations in contractile function, or the effectiveness of longitudinal, radial…