…embolism, bleeding, stroke, etc.) as well as cases where the cause does not fall into the other categories. Trauma Cardiac arrest caused by violence, accidents…

…books and online resources fall into the trap of oversimplification. Physicians, nurses, paramedics and physician assistants who rely on such books will realize their shortcomings…

…a chronic, progressive, and highly dynamic inflammatory disease of the arterial wall. It is characterized by the subendothelial accumulation of apolipoprotein B containing lipoproteins, macrophage…

…that clots before the smears are made is unusable, no matter how well the puncture went. Indications Unexplained cytopenia in one or more cell lines…

…apart. A wound through the full thickness of the dermis, particularly over joints and in cosmetically sensitive areas. Superficial wounds with well apposed edges, abrasions…

…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…

…speckle tracking As previously discussed, the left ventricular wall can be subdivided into three layers: the inner lining ( endocardium ), a thick muscle layer ( myocardium ) and…

…single most important tool when intubation fails, since it restores oxygenation without requiring a view down into the larynx. The difficult airway rarely kills because…

…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…

…choice) Slower, 20–30 min Intradermal (ID) Tuberculin (PPD), skin prick testing, a local anaesthetic weal, BCG Slow, local effect Contraindications Absolute: Infection, a wound…

…why, or the patient at risk of carbon dioxide retention is given 15 litres on a reservoir mask and drifts off into a respiratory acidosis…

…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…

…mitigation of reperfusion injury are complementary objectives of initial STEMI management. The principal acute complications fall into two broad categories: Electrical complications , particularly ventricular arrhythmias…

…an opioid can be given for the pain, but the effect on the bowel must be taken into account). Known allergy to the preparation — rare…

…the 99th percentile upper reference limit (URL). The injury is considered acute if there is a documented rise and/or fall of cTn values. However…

…clinical presentation of VT, with a deep dive into the underlying etiologies ranging from benign idiopathic variants to complex scar related and genetic substrates. Furthermore…

…gravity and slow movement; those that fail usually do so because the patient tenses up with pain, or because the operator pulls harder rather than…

…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…

…may present with STEMI. Pathophysiology and causes MINOCA encompasses several distinct mechanisms. These may be broadly divided into coronary causes, myocardial causes, and extracardiac or…

…However, full recovery of contractility may take hours to days. It is generally stated that myocardium resists 20 minutes of severe hypoxia before cell death…

…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…

…atria begin to contract again. An unsynchronised shock that happens to fall in the T wave can precipitate ventricular fibrillation, and cardioversion of fibrillation of…

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

…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…

…with the same risk as manifest hypertension. Non dipping: a nocturnal fall in pressure of < 10% of the daytime value; an independent risk marker…

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

…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…

…tachypnoea, cold periphery Almost always Pulsus paradoxus above 10 mmHg A fall in systolic blood pressure during inspiration; one of the most useful signs Low…

…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…

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

…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…

…interpreted as specialist investigations. Both fail more often for practical than for medical reasons: the cuff is in the wrong place, the electrodes come off…

…is measured immediately after treadmill walking or after repeated heel raises. A fall of ≥ 20 % after exercise confirms peripheral arterial disease. Toe brachial index (TBI)…

…112 mmol/L may be relatively unaffected, while a rapid fall from 140 to 125 mmol/L can cause marked symptoms [4]. Grade Plasma sodium : …

…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…

…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…

…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…

…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…

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

…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…

…minutes. 3. Attach defibrillator pads if the patient is unstable or at marked risk of arrhythmia. 4. Take a full blood count, electrolytes, creatinine, glucose…

…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…

…The two pathways DBD DCD : : : Full name Donation after death by neurological criteria (total brain infarction) Donation after circulatory death Starting point A ventilated patient…

…and the incidence is particularly high after hip fracture, major surgery and intensive care [1,2]. The condition is associated with falls, aspiration, pressure sores…

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

…intravenous or intraosseous access, a targeted history At 5 minutes A full, adequate dose of a benzodiazepine About 10 minutes Repeat the benzodiazepine once if…

…kidney function declines and as albuminuria increases. When eGFR falls below approximately 60–75 mL/min/1.73 m², the probability of coronary artery disease…

…regarded as a series of completely discrete diseases. Heart failure extends across the full range of LVEF, and echocardiographic measurement is subject to meaningful variability…

…through the pulmonary circulation. Consequently, left ventricular filling falls and cardiac output may become markedly depressed. Right sided filling pressures—including central venous, right atrial…

…In heavy smokers, cardiovascular risk falls within five years of stopping but may remain elevated thereafter. The overall health benefit is greater still when reductions…

…decline in blood oxygen saturation ensues. Within 1 2 minutes, oxygen saturation falls to approximately 60%, leading to unconsciousness. The myocardium responds to hypoxia by…

…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…

…has an abrupt onset, although a brief warm up phase lasting approximately 5 to 10 seconds may precede the full tachycardia. It is characterized by…

…Non hyperemic pressure ratios (instantaneous wave free ratio [iFR], resting full cycle ratio [RFR], and related resting indices) simplified the procedure by removing the need…

…Because the impulse originates in the atria it will pass through the bundle of His and therefore produce a normal QRS complex (provided that intraventricular…

…ventricular contractions or just ventricular beats/contractions/complexes . These terms will be used interchangeably in this discussion. A premature ventricular complex is recognized on the…

…in the following circumstances: During sleep . Well trained individuals display SB at rest due to high vagal tone. These individuals have developed a highly efficient…

…compressions ineffective. For instance, a traumatic hemorrhage can deplete intravascular volume to such an extent that chest compressions fail to generate stroke volumes. Consequently, addressing…

…of a serious condition Finding Significance : : Inability to speak in full sentences Marked work of breathing Use of accessory respiratory muscles or paradoxical abdominal breathing…

…attack Acute severe attack Life threatening attack : : : : Speech Full sentences Cannot complete a sentence in one breath Single words or unable to speak Position and…