…unsuccessful resuscitation within a 4 minute window, an emergent cesarean section should be considered to optimize fetal outcomes. The gestational age should ideally exceed 20…

…precipitating state resolves. The distinction is therefore not based on the BP value alone: Feature Hypertensive emergency Hypertensive urgency BP Often ≥180/110 mmHg; no…

…patient. Rate control in the stable patient Drug Situation Comment : : : Beta blocker (metoprolol) First choice in most cases The IV dose is titrated slowly. Caution…

Emergency medicine Myocardial ischemia and infarction Definition and pathophysiology Right ventricular infarction (RVI) is myocardial necrosis involving the right ventricle, most often occurring in association…

Cardiology Emergency medicine Definition and Pathophysiology Acute aortic syndromes comprise classic aortic dissection, intramural haematoma (IMH), and penetrating atherosclerotic ulcer (PAU). Aortic dissection accounts for…

Cardiology Emergency medicine Definition and pathophysiology Acute pulmonary embolism (PE) is classified according to haemodynamic status, clinical severity, evidence of right ventricular (RV) dysfunction, and…

…medicine Emergency medicine Definition and pathophysiology Acute limb ischaemia (ALI) is an abrupt reduction in arterial perfusion of an upper or lower limb that causes…

Arrhythmias and arrhythmology Emergency medicine Pharmacology & dosing Definition and Pathophysiology Bradycardia encompasses a spectrum of rhythm disturbances characterized by an inappropriately slow heart rate. Within…

Cardiology Emergency medicine Procedurer Definition and Pathophysiology Cardiac tamponade is a life threatening clinical syndrome in which increased intrapericardial pressure compresses the heart and impairs…

…for the majority of cases, and the great majority of objects can be removed in general practice or in the emergency department with simple equipment…

…care Victims of out of hospital cardiac arrest (OHCA) who achieve ROSC in the emergency room (ER) are transferred to the intensive care unit (ICU)…

…and just great. A must if your into emergency medicine. Broome docs Dr Casey Parker's site covers a wide range of topics. The archive…

…palpitations, back pain and selected cases of upper abdominal pain. An ECG recording costs approximately $10 (10€) and may reduce morbidity and mortality substantially in…

…atrial flutter, and in selected cases of paroxysmal supraventricular tachycardia. Due to its profound pro arrhythmic effects and lack of compelling data regarding morbidity and…

…TdP). Drug induced LQTS and TdP represent a multifactorial clinical entity that typically emerges when multiple modifiable and non modifiable risk factors converge. The electrophysiological…

…the majority of cases are caused by calcification of the aortic valve. Calcification has traditionally been considered a passive degenerative process, but emerging evidence suggests…

…involving more than 11,000 cardiac arrest cases, the correlation between the initial pupillary reflex (observed upon emergency department arrival) and the neurological status assessed…

…case of long no flow or low flow periods. Under such circumstances, the efficacy of compressions and defibrillation diminishes considerably. Extracorporeal Life Support (ECLS) emerges…

…cardiac arrest (IHCA). Initiating or withholding CPR In cases of an unexpected cardiac arrest in an individual with any likelihood of survival, cardiopulmonary resuscitation (CPR…

…and in some cases substantially narrowed, the role of revascularization itself in stable coronary artery disease, while a distinct evidence base has emerged for coronary…

…nearby, bystanders must respond immediately by summoning help (calling the emergency dispatch centre on the local emergency number) and initiate BLS (basic life support). BASIC…

…of vital signs is crucial. Exceptionally high survival rates have been documented in cases of accidental hypothermia followed by cardiac arrest. For unwitnessed cardiac arrests…

…by metastasis or invasion from surrounding tissue. Differential Diagnostics There are several differential diagnoses in the case of cardiac masses. The characteristics of the patient…

…Utstein guidelines (Table 1). The broad categories of causes are considered necessary due to the uncertainties prevailing in the pre hospital setting ( Perkins et al. )…

…recordings confirming a bradyarrhythmia. Potentially reversible causes should be pursued (Table 2). Figure 1. Management of acute bradycardia in the emergency setting. Parameter Assessment A…

Arrhythmias and arrhythmology ECG Ventricular tachycardia (VT): types, causes, ECG features and management This chapter deals with ventricular tachycardia from a clinical perspective, with emphasis…

…cases, periodic paralysis. Nevertheless, many patients are normokalaemic and have no distinctive symptoms attributable to aldosterone excess. Cardiovascular complications may dominate the presentation or emerge…

…lavage is infrequently employed due to aspiration risks and inconclusive evidence. However, in cases of iron, lithium, or potassium intoxication where lavage might prove beneficial…

…of ventricular tachyarrhythmias. Theoretically, ICDs could treat 99% of all cardiac arrests caused by ventricular tachyarrhythmias (which are the majority of cases). Yet, only a…

…these patients. This integrated approach relies on seamless collaboration between the dispatch center, ambulance services, emergency department (ED), catheterization laboratory, and cardiology ward. Each component…

…STE ACS/STEMI have inadequate microvascular flow despite patent epicardial blood flow. In such cases, the ECG will be more sensitive (and show a lesser…

…The emergency evaluation of non traumatic chest discomfort is structured around three principal diagnostic categories: Myocardial ischaemia , particularly acute coronary syndrome (ACS). Other cardiopulmonary causes…

…initial rhythm is atrial fibrillation. The fifth beat is a ventricular premature beat. A ventricular tachycardia (VT) emerges. As evident, ventricular tachycardia may appear more…

…guide the choice of agent. Calcium channel blockers (CCB) Clevidipine Drug Clevidipine Brand names Cleviprex ® Indications Hypertension and hypertensive emergency. Treatment of postoperative hypertension…

…guide the choice of agent. Calcium channel blockers (CCB) Clevidipine Drug Clevidipine Brand names Cleviprex ® Indications Hypertension and hypertensive emergency. Treatment of postoperative hypertension…

…the causes are pulmonary embolism, pulmonary hypertension, septum defects, etc. Right ventricular load is thus an issue that is raised both in outpatient and emergency…

…hypocalcaemia, calcium channel blocker poisoning 0.2 mL/kg Sodium bicarbonate 50 mmol in hyperkalaemia or tricyclic poisoning 1 mmol/kg Reversible causes: hypoxia, hypovolaemia…

Emergency medicine Lathundar Differential Diagnosis of Chest Pain: A Clinical Overview The evaluation of acute chest discomfort requires a systematic differential diagnosis, as the syndrome…

Clinical chemistry & laboratory medicine Emergency medicine Myocardial ischemia and infarction Definition and Pathophysiological Basis High sensitivity cardiac troponin (hs cTn) assays detect circulating troponin released…

Nicardipine Drug Nicardipine Brand names Cardene ® Indications Hypertension, hypertensive emergency/crisis. Pregnancy induced hypertension. Angina pectoris Prinzmetal's angina Mechanism of action Nicardipine is…

…which must be tapered in a controlled fashion). The management is the opposite in each case. Equivalent doses Agent Equivalent glucocorticoid dose Mineralocorticoid effect Biological…

…Phentolamine reduces blood pressure while increasing catecholamine activity. Effects Primarily causes afterload reduction. Time to onset of action 1 to 2 minutes Duration of action…

…chest pain: differential diagnoses, evaluation and management Chest pain is one of the most common symptoms in the emergency department, as well as in primary…

…AV block 1, 2 & 3) Evaluation of patients with suspected AV blocks requires a thorough medical history (with emphasis on causes of AV blocks; please…

…description of the quality of the dizziness — rotatory vertigo, unsteadiness or faintness — discriminates poorly between dangerous and benign causes. Ask primarily how the symptoms began…

…VF). It is primarily intended for use in an emergency setting. The manual includes the following sections (click to navigate to the section): Classification of…

…VF). It is primarily intended for use in an emergency setting. The manual includes the following sections (click to navigate to the section): Classification of…

…1. Assess airway, breathing and circulation. 2. Assess the neurological symptoms and at the same time exclude other acute causes, for example hypoglycaemia, poisoning, stroke…

…In recent years, the concept of a distinct "cough hypersensitivity syndrome" has emerged, emphasizing the putative role of sensitized sensory nerve endings and afferent neural…

…In out of hospital cardiac arrest (OHCA) the initial rhythm is recorded by the EMS (emergency medical service) team upon their arrival at the scene…

…fire brigade, emergency rescue, and security guards) in BLS is key to improving outcomes in OHCA and may be the single strongest factor driving improvement…

…downstream, causing microvascular embolization (i.e occluding smaller vessels downstream). The thrombosis causes occlusion of the artery; blood flow may be partially or completely obstructed…

…Hypersensitivity. Electrolyte disturbances Hypokalemia. Hyperkalemia. Hypercalcemia. Benign causes Well trained athletes display bradycardia at rest. Bradycardia during sleep is considered normal. Tricyclic antidepressants : amitriptyline, amoxapine…

…setting of stable ischemic heart disease, an atherosclerotic plaque causes ischemia when myocardial oxygen demand exceeds the oxygen supply. The most characteristic manifestation of ischemic…

…soft tube (Ch 8–12) of polyurethane or silicone for nutrition, since it causes less mucosal irritation with longer term use. A water soluble lubricant…

…may even simulatesinus rhythm. Third degree AV block causes cardiac arrest unless an escape rhythm emerges. The escape rhythm may have narrow or wide QRS…

…decades but carries several limitations, most notably its reliance on ST segment elevation as the key trigger for emergent reperfusion therapy. This approach fails to…

Njurmedicin Akutsjukvård Lathundar Emergency management in brief The intensity of treatment is governed by ECG changes, symptoms, the rate of rise, renal function and the…

Endokrinologi & metabolism Akutsjukvård Lathundar Emergency overview Measure the plasma glucose immediately in everyone with a reduced level of consciousness, seizures, confusion, a change in behaviour…