…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…

…understanding of cardiovascular pathophysiology and electrocardiology. Unfortunately, numerous books and online resources fall into the trap of oversimplification. Physicians, nurses, paramedics and physician assistants who…

…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…

…the effect on the bowel must be taken into account). Known allergy to the preparation — rare; itching and urticaria are usually due to histamine release…

…The Fourth Universal Definition classifies MI into five distinct subtypes based on pathophysiology and clinical context: Type 1 MI: Caused by atherothrombotic coronary artery disease…

…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…

…etiology of VT is broadly dichotomized into structural heart disease (SHD) and structurally normal hearts, a division that profoundly influences prognosis and therapeutic decision making…

…distinction between NSTEMI and UA hinges entirely on the presence of myocardial necrosis. NSTEMI is confirmed by a typical rise and/or fall of high…

…mask is inserted even with a full stomach. Preparation and equipment A laryngeal mask of the correct size plus one size above and one below…

…radial, and circumferential contraction. Thus, methods such as ejection fraction may provide easily obtained parameters, but fail to provide important insights into left ventricular mechanics…

…work best exploit time, gravity and slow movement; those that fail usually do so because the patient tenses up with pain, or because the operator…

…or arrhythmia. 4. Shift potassium into the cells with insulin and glucose. Add high dose salbutamol in marked hyperkalaemia if there is no contraindication. 5…

…A paretic limb — poorer absorption. Injection into an arm with a dialysis fistula. Preparation and equipment Hand disinfection; gloves where there is a risk of…

…is given 15 litres on a reservoir mask and drifts off into a respiratory acidosis. Treatment is guided by the saturation and the blood gas…

…tap water or sodium chloride 9 mg/mL. The volume matters more than the fluid; irrigate under pressure through a 20 mL syringe and a…

…artery dissection (SCAD) Standard angiography may fail to demonstrate plaque disruption, intraluminal thrombus, or dissection. Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) can reveal…

…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…

…Injection of contrast media into the ventricle will instead reveal that the apical portion of the left ventricle is dilated (hence the term apical ballooning…

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

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

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

…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…

…stenosis Known — perform the test only on a clear indication and with full preparedness Moderate to severe aortic stenosis without symptoms Individual assessment Hypertrophic cardiomyopathy…

…specific 99th percentile upper reference limit. It is classified as acute when serial measurements demonstrate a rise and/or fall. A stable elevation indicates chronic…

…least two occasions, and preferably confirmation by home measurement or 24 hour recording — the thresholds for which are lower than for office measurement. Classification of…

…alert value < 3.9 mmol/L but at least 3.0 mmol/L Prompt action is needed to prevent a further fall Level 2…

…1 ABCDE, full vital signs, level of consciousness, and repeated assessment of the circulation and breathing 2 Assess whether the patient has sepsis, septic shock…

…With ultrasound guidance, the point at which the fluid lies most superficially is chosen and the needle is followed all the way in, which has…

…CYP2C9 variants) (1 point) E xcessive fall risk (1 point) S troke (1 point) HEMORR₂HAGES Score Risk category Incidence of major bleeding (per 100 patient…

…produces an exaggerated inspiratory fall in systemic systolic blood pressure, termed pulsus paradoxus. Tamponade is therefore characterized haemodynamically by elevation and near equalization of diastolic…

…both hypovolaemia and venous congestion. 4. Take an urgent panel: creatinine, urea, sodium, potassium, bicarbonate or blood gas, calcium, phosphate, glucose and a full blood…

…renal disease and secondary hypertension, and lead to one dose being moved to the evening. The fall can only be calculated if the diary states…

…after vascular surgery or endovascular intervention. Assessment of healing potential in ulcers and before deciding the level of amputation. Contraindications There are no absolute contraindications…

…amount of water is too great in relation to the amount of dissolved cations [3]. The first five minutes 1. Assess airway, breathing and circulation…

…autonomic reflexes that influence the haemodynamic result. Reflex tachycardia is the rule after a rapid fall in blood pressure. Drug Indications Dosing α1 β1 β2…

…and UA may be similar. NSTEMI is diagnosed when typical ischaemic symptoms occur without persistent ST segment elevation, accompanied by a rise and subsequent fall…

…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…

ECG Exercise stress test Definition and clinical role Exercise electrocardiographic testing is a standardized assessment in which a patient performs progressively increasing external work, usually…

…reaches hospital early. The benefit of both methods falls steeply with the time since ingestion, and both can harm the patient through aspiration. Contact your…

…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…

…is unstable or at marked risk of arrhythmia. 4. Take a full blood count, electrolytes, creatinine, glucose, high sensitivity troponin and, where needed, coagulation tests…

…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…

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

…The condition is associated with falls, aspiration, pressure sores, loss of function, longer length of stay, institutional care, readmission, cognitive decline and increased mortality [3…

… full sterile attire for therapeutic drainage with an indwelling catheter. Lidocaine 10 mg/mL, 5–10 mL, 25 G for the skin wheal and 21…

…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…

…cardiovascular disease (CVD) and cardiovascular mortality. Cardiovascular risk rises progressively as kidney function declines and as albuminuria increases. When eGFR falls below approximately 60–75…

…of completely discrete diseases. Heart failure extends across the full range of LVEF, and echocardiographic measurement is subject to meaningful variability. HFmrEF may therefore represent…

…results from impaired right ventricular contraction and reduced forward flow through the pulmonary circulation. Consequently, left ventricular filling falls and cardiac output may become markedly…

…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…

…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…

…a dose of 30 ml/kg. Should fluid resuscitation fail to maintain a mean arterial pressure (MAP) above 65 mmHg, consider the initiation of vasopressor…

…particularly obstructive pulmonary disease, the use of theophylline, and elevated catecholamine states. EAT typically has an abrupt onset, although a brief warm up phase lasting…

…resting full cycle ratio [RFR], and related resting indices) simplified the procedure by removing the need for pharmacologic hyperemia, and angiography derived indices (quantitative flow…

Arrhythmias and arrhythmology ECG Premature atrial contraction (premature atrial beat / complex) A premature atrial contraction is produced by an impulse discharged from an ectopic focus…

…and induces a delay to the next sinus beat (the RR interval is increased after a premature ventricular complex). This yields more time to fill…

…infarction. Sinus Node Dysfunction (SND) – Sinus node dysfunction implies that the cells of the sinoatrial node are defective and fail to generate electrical impulses. Side…

…Nonetheless, prompt interventions can reverse cardiac arrest and survivors of traumatic cardiac arrest often exhibit favorable neurological outcomes ( Rawshani et al ). Traumatic cardiac arrests typically…

…cancer and previous venous thromboembolism. A documented decision on the ceiling of care. Signs of a serious condition Finding Significance : : Inability to speak in full…

…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…