…then rebreathes carbon dioxide from the mask Mask with a reservoir 10–15 L/min 60–90 % For acute severe hypoxaemia. Fill the bag before…

…their first encounter with an ECG in reality. Books that claim to make it "simple" can provide a quick entry point but fail to delve…

…myocardial injury, demonstrated by a rise and/or fall in cardiac troponin with at least one value above the 99th percentile upper reference limit; and…

…ventricle are compressed, with elevation of their diastolic pressures. Right sided filling becomes increasingly dependent on the fall in intrathoracic pressure during inspiration. The inspiratory…

…commonly stated that approximately 80% of all cardiac arrests are caused by acute or chronic coronary artery disease, with the latter being the most common…

…Comment : : : Reticulocytes 20–100 ×10⁹/L Distinguishes a production defect from haemolysis or bleeding Ferritin 15–300 µg/L (women 10–150) An acute phase…

…accompanied by a rise and subsequent fall in cardiac specific troponin attributable to myocardial ischaemia. UA presents with compatible ischaemic symptoms but without cardiac specific…

…associated with a working diagnosis of persistent ST segment elevation or an accepted equivalent in the setting of ischaemic symptoms. The immediate pathophysiological objective is…

…repeat treatment until the patient has recovered. 7. Follow up with a meal or with continued glucose administration adapted to the cause. 8. Identify drugs…

…or below 1.0 × 10⁹/L with an expected fall to below 0.5 × 10⁹/L within 48 hours Profound neutropenia A neutrophil count below…

…HEMORR₂HAGES bleeding risk score is a clinical tool developed to assess the risk of major bleeding in patients with atrial fibrillation (AF) on anticoagulation therapy…

…is required. Patients with suggestive symptoms, signs or a medical history indicating possible secondary hypertension should undergo appropriate screening for an underlying secondary cause. Evaluation…

…a documented rise and/or fall of cTn values. However, myocardial injury alone is an entity in itself and may arise from non ischaemic cardiac…

…Acute myocardial injury , demonstrated by a rise and/or fall in cTn with at least one value above the 99th percentile URL; and Clinical evidence…

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

…No smoking or coffee in the preceding hour. Remove socks and any compression stockings. Avoid measuring the arm pressure on the side with a dialysis…

…spinal needle or the needle from a pericardiocentesis set), 10 mL and 20 mL syringes, a three way tap. A Seldinger set with a guidewire…

…dynamic sequence of ventricular activation. PMVT is frequently associated with acute myocardial ischemia, electrolyte derangements, or underlying channelopathies (e.g., Torsades de Pointes in Long…

…bicarbonate or blood gas, calcium, phosphate, glucose and a full blood count. 5. Take a urine dipstick and, where the cause is unclear or a…

…NSTEMI is confirmed by a typical rise and/or fall of high sensitivity cardiac troponin (hs cTn), with at least one value above the 99th…

…or a haemoglobin below the applicable transfusion threshold (see below). Ongoing bleeding with haemodynamic compromise, whatever the current haemoglobin — haemoglobin falls late in acute haemorrhage…

…of both methods falls steeply with the time since ingestion, and both can harm the patient through aspiration. Contact your national or regional poison control…

…Significance : : Inability to speak in full sentences Marked work of breathing Use of accessory respiratory muscles or paradoxical abdominal breathing Impending muscle fatigue Respiratory rate…

…needed around the clock. A continuous infusion or repeated doses, according to the local protocol Renal failure The insulin requirement falls . Reduce the dose and…

…to creatinine ratio (UACR) above 30 mg/g—or both. The eGFR is generally estimated from serum creatinine using the Chronic Kidney Disease Epidemiology Collaboration…

…in which the heart cannot provide blood flow commensurate with the body’s requirements or can do so only at the cost of elevated filling…

…instead as an ectopic atrial rhythm (EAR) . Ectopic atrial tachycardia (EAT) most commonly occurs in individuals with underlying structural or electrical heart disease. Less frequently…

…hernia or visible abdominal wall collaterals (caput medusae) Puncture at least a few centimetres away from them Full bladder Have the patient void, or catheterise…

…from seizure onset Action : : 0 to 5 minutes ABCDE, start timing, glucose, monitoring, intravenous or intraosseous access, a targeted history At 5 minutes A full…

…Consequently, congestion may occur across the full range of left ventricular ejection fraction and may result from systolic dysfunction, diastolic dysfunction, or both. The clinical…

…appearance), as compared with the sinus P wave. The appearance depends on the location of the ectopic focus from which the impulse is discharged. If…

…complex). This yields more time to fill the ventricles with blood (increased ventricular filling). The person with premature beats might perceive this as palpitations, because…

…bleeding with haemodynamic instability, for example a systolic blood pressure below 90 mmHg, a narrow pulse pressure, peripheral vasoconstriction, impaired consciousness, a rising lactate or…

…tachycardia or ventricular fibrillation. The likelihood of clinically significant EMI is generally low, particularly with bipolar electrocautery performed away from the device and with monopolar…

…severity The presentation may range from mild right ventricular impairment to cardiogenic shock. Patients with hypotension, marked low output, or persistent severe symptoms require close…

…with avoidance of second hand smoke and, where possible, other inhaled nicotine products. In cardiovascular medicine, the objective is not merely to reduce cigarette consumption…

…ventricle. Studies from the US and Japan has estimated that up to 2% of patients referred to PCI with a suspicion of STE ACS/STEMI…

…compressions fail to generate stroke volumes. Consequently, addressing reversible causes of cardiac arrest becomes more critical than performing chest compressions. Hemorrhages, either manifesting externally or…

…full blood count, electrolytes, creatinine, coagulation tests and troponin are taken in parallel but must not delay treatment in a patient without suspected coagulopathy or…

…and the donor care The time from withdrawal of treatment to circulatory arrest Indications An intensive care patient with severe brain injury in whom total…

…no reason to refrain from investigating postmenopausal bleeding or a visible cervical lesion. Contraindications There are no absolute contraindications, but refrain or adapt in: The…

…3. Give intravenous calcium in the presence of hyperkalaemic ECG changes or arrhythmia. 4. Shift potassium into the cells with insulin and glucose. Add high…

…3.0 Thereafter usually an antiplatelet drug or nothing Preparation and equipment INR, full blood count, creatinine with eGFR and liver function tests before starting…

…or cardiovascular death. Preservation of mobility, cognition, independence, functional capacity, and quality of life may be equally important therapeutic objectives. Evidence from randomized trials is…

…few minutes from collapse. Table 1 shows the number needed to treat (NNT) for various interventions involved in BLS and ACLS. Intervention BLS or ACLS…

…and can guide resuscitative efforts. If the patient presents with hypotension or has a lactate level exceeding 4 mmol/l, commence an intravenous fluid resuscitation…

…fail to provide important insights into left ventricular mechanics. Regional differences in contractile function are of utmost importance, particularly in the setting of (confirmed or…

…or the time of onset uncertain, choose the more cautious course. Anticoagulation Assess the risk with CHA₂DS₂ VA (the sex category has been removed from…

…not the skin. Aspiration needle (iliac crest or sternal needle with stylet) and a Jamshidi type biopsy needle. Syringes: a small 5–10 mL syringe…

…1. Check the mask, remove air from the cuff so that it is flat with a slightly upturned leading edge, and lubricate the dorsal surface…

…Ability to perform activities of daily living Cognitive status Risk of falls Symptoms or history suggesting orthostatic hypotension Multimorbidity Polypharmacy and overall therapeutic burden Life…

…result from a mismatch between myocardial oxygen supply and demand. The clinical history should therefore be examined for potential physiological or systemic stressors, with treatment…

…mechanism. Sequential activation implies that the atria are activated first and they fill the ventricles with adequate volumes of blood before ventricular contraction commences. To…

…area), which may receive oxygen from collateral vessels. In cardiac arrest, there is no cerebral perfusion, with an equal degree of hypoxia in all neurons…

CPR The course from sudden cardiac arrest (SCA) to death follows a pathophysiological process that affects the effectiveness of the interventions. Numerous studies demonstrate that…

…INR ≥ 2.0 checked weekly on warfarin, or documented well managed DOAC therapy with no missed doses. A single missed DOAC dose makes the pretreatment…

…indication and with full preparedness Moderate to severe aortic stenosis without symptoms Individual assessment Hypertrophic cardiomyopathy with outflow tract obstruction Caution Tachyarrhythmia or bradyarrhythmia Rate…

…normal readings at home or on 24 hour recording. Masked hypertension: normal in the office but raised outside it — associated with the same risk as…

…Use the arm with the higher pressure, or the non dominant arm if the values are equal. Check against a manual measurement and document the…

…in the emergency department, the intensive care or coronary care unit, and the operating theatre. Careful electrocardiographic and haemodynamic monitoring with ECG, a central venous…