…In the "can't intubate, can't oxygenate" situation there are no contraindications — a laryngeal mask is inserted even with a full stomach. Preparation and…

…in acute severe pain Practical points during titration: Give the injection slowly over at least a minute; a rapid injection causes nausea and a fall…

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

…The principal acute complications fall into two broad categories: Electrical complications , particularly ventricular arrhythmias. Mechanical or pump failure complications , including heart failure and cardiogenic shock…

…does not fall into the other categories. Trauma Cardiac arrest caused by violence, accidents, burns, or other trauma. Drowning Cardiac arrest due to drowning Electrocution…

…Torsades de Pointes in Long QT Syndrome) [1] . Underlying Etiologies The etiology of VT is broadly dichotomized into structural heart disease (SHD) and structurally normal…

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

…upper reference limit (URL). It is considered acute when there is a rise and/or fall in cTn values. An elevated cTn alone does not…

…rise and/or fall of high sensitivity cardiac troponin (hs cTn), with at least one value above the 99th percentile upper reference limit (URL) in…

…marked reduction in cell metabolism and thus prolongs survival. Myocardial stunning starts to normalize within minutes after the hypoxia is relieved. However, full recovery of…

…potassium and glucose if a rapid result is needed. Creatinine, urea, sodium, calcium and magnesium. Full blood count. Plasma glucose before insulin. Creatine kinase in…

…under pressure through a 20 mL syringe and a large bore needle. Chlorhexidine in alcohol to the skin around the wound — not into the wound…

…organized into several sheets wrapping around the ventricle with varying orientation. This organization allows the left ventricle to contract in a highly sophisticated and effective…

…quickly and firmly, to its full length. 5. Aspiration is not needed for vaccination in the deltoid and vastus lateralis — there are no large vessels…

…with corroborating evidence of infarction caused by ischaemia, and no obstructive stenosis in a major epicardial coronary artery. Non obstructive disease is generally defined as…

…particular care in: A risk of hypercapnic respiratory failure — COPD, severe obesity with hypoventilation, neuromuscular disease, marked chest wall deformity, severe bronchiectasis and cystic fibrosis…

…block The standard in finger dislocation Procedural sedation Propofol, ketamine or a combination. It requires a fasting history, two people, full monitoring and airway preparedness…

…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…

…term apical ballooning syndrome ). This syndrome was first descried in 1991 in Japan and the authors termed it takotsubo , which is the Japanese word for…

…draws in peripheral blood and dilutes the specimen. Marrow clots within seconds; the smears must be made before that. 7. Then aspirate further volume into…

…arrhythmias and recovery. A patient who stops at a low workload with a fall in blood pressure is a high risk patient even with normal…

…abdominal pain or a rapid deterioration in general condition may be the only signs of infection. Corticosteroids and other immunosuppressive treatments can blunt the febrile…

…fell asleep and got up. Holter ECG and longer rhythm monitoring Indications Palpitations, presyncope or syncope of suspected arrhythmic origin. Assessment of rate control in…

…confusion, a change in behaviour, collapse or an acute neurological deficit. Hypoglycaemia can cause hemiparesis, aphasia and radiological changes resembling ischaemic stroke. Glucose measurement is…

…right atrium and right ventricle are compressed, with elevation of their diastolic pressures. Right sided filling becomes increasingly dependent on the fall in intrathoracic pressure…

…value in twenty falls outside them . Order twelve tests in a healthy person and the probability is around 46 % that at least one will fall…

…An unsynchronised shock that happens to fall in the T wave can precipitate ventricular fibrillation, and cardioversion of fibrillation of unknown duration without anticoagulation can…

…exercise capacity, an abnormal blood pressure response or ventricular arrhythmias. A fall in systolic blood pressure, particularly when accompanied by evidence of ischaemia, may indicate…

…the HEMORR₂HAGES, ATRIA, and HAS BLED bleeding risk prediction scores in patients with atrial fibrillation undergoing anticoagulation: the AMADEUS study. J Am Coll Cardiol . 2012…

…by a rise and/or fall in cardiac troponin with at least one value above the 99th percentile upper reference limit; and Clinical evidence of…

…cuff at heart level Measure in both arms at the first visit; a difference 15 mmHg suggests vascular disease, and the arm with the higher…

…haemodynamics. Most agents exert both vasopressor and inotropic effects (Figure 1). What follows is a quick reference for their use in the emergency department, the…

…other than the conditions in which the procedure is the wrong treatment : Aortic dissection with haemopericardium — drainage can increase the bleeding and worsen the prognosis…

…without persistent ST segment elevation, accompanied by a rise and subsequent fall in cardiac specific troponin attributable to myocardial ischaemia. UA presents with compatible ischaemic…

…brachial index (TBI). The digital arteries rarely calcify, which makes toe pressure the method of choice in diabetes and renal failure. A normal TBI is ≥

…of function and may rise only after a substantial fall in glomerular filtration. The value is affected by muscle mass, nutrition, drugs and fluid balance…

…the emergency treatment Severe symptoms The following symptoms indicate hyponatraemic encephalopathy and warrant immediate treatment in the absence of another obvious explanation: Seizures A deeply…

…the arms. Orthostatic hypotension: a fall of ≥20 mmHg in SBP and/or ≥10 mmHg in DBP at 1 or 3 minutes after standing, following…

Akutsjukvård Psykiatri Lathundar Delirium in older adults: quick reference A quick reference for ward and on call physicians: recognise hypoactive delirium, stabilise the patient, work…

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

…coronary perfusion, particularly in patients with coronary disease. Excessive systolic reduction may be associated with falls, syncope, renal deterioration, functional decline, and cognitive impairment. Heart…

…attack : : : : Speech Full sentences Cannot complete a sentence in one breath Single words or unable to speak Position and behaviour Can lie down or sit…

…falls, and functional deterioration may have greater consequences in frail patients. Clinical Assessment Frailty and Functional Status Treatment decisions should not be based on age…

…site Preparation and equipment Ultrasound with a curved array probe. Sterile preparation (chlorhexidine in alcohol 5 mg/mL), sterile gloves, fenestrated drape; full sterile attire…

…very serious poisonings in which the patient reaches hospital early. The benefit of both methods falls steeply with the time since ingestion, and both can…

…sac impedes venous return to the right atrium. Similarly, in tension pneumothorax, the elevated intrathoracic pressure obstructs the venous return via the superior and infer

…haemoglobin and ionised calcium, together with a full blood count, INR, APTT and fibrinogen. 7. Give tranexamic acid where it is indicated. 8. Proceed in…

…At 5 minutes A full, adequate dose of a benzodiazepine About 10 minutes Repeat the benzodiazepine once if the seizure persists, and prepare step 2…

…Overview Acute coronary syndrome comprises STEMI, NSTEMI and unstable angina. Management begins in parallel with the diagnostic work up. Obtain an interpretable 12 lead ECG…

…regulated in Swedish law and practice; the legal framework, the consent model and the time limits differ between countries. The two pathways DBD DCD : : : Full…

…oxygen saturation falls to approximately 60%, leading to unconsciousness. The myocardium responds to hypoxia by downregulating metabolism and thus contractility (a consistent finding in acute…

…In the setting of acute heart failure, N terminal pro B type natriuretic peptide (NT proBNP) values, potassium concentrations, and estimated glomerular filtration rate (eGFR…

…symptoms of RVI commonly occur in the setting of an inferior myocardial infarction. The available source material emphasizes the haemodynamic and physical manifestations rather than…

…guidance in selecting lesions for percutaneous coronary intervention (PCI). Non hyperemic pressure ratios (instantaneous wave free ratio [iFR], resting full cycle ratio [RFR], and related…

…with haemodynamic compromise, whatever the current haemoglobin — haemoglobin falls late in acute haemorrhage and a normal value does not exclude significant blood loss. Massive haemorrhage…

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

…cap, mask, sterile gown, sterile gloves and a large full body drape. Lidocaine 10 mg/mL for local anaesthesia, normal saline to flush all lumens…

…falls within five years of stopping but may remain elevated thereafter. The overall health benefit is greater still when reductions in non cardiovascular morbidity and…

…arrest in septic patients; timely oxygenation can potentially prevent circulatory collapse. Initiate an intravenous bolus of 500 ml crystalloid solution . Assess the esponse and repeat…

…discharged near the atrioventricular node, the atria will be depolarized in the opposite direction and thus generate a negative (retrograde) P wave (Figure 2). Thus…