…as well as cases where the cause does not fall into the other categories. Trauma Cardiac arrest caused by violence, accidents, burns, or other trauma…

…from laboratory errors but from the wrong blood being given to the wrong patient — a mislabelled tube, or an identity check performed at the nurses…

…Normotension Normal Normal White coat hypertension Raised Normal Masked hypertension Normal Raised Established hypertension Raised Raised Nocturnal dipping: the pressure normally falls by 10–20…

…in respiratory compromise, low saturation, suspected carbon dioxide retention, reduced consciousness, or when NIV is being considered. 4. Give short acting bronchodilators. 5. Give a…

…give the first dose of broad spectrum antibiotics within 60 minutes of triage or arrival. This is supported by international guidelines on neutropenic fever [2]…

…delivered while the patient deteriorates. Indications Emergency, irrespective of duration and anticoagulation status: Tachyarrhythmia with haemodynamic compromise: hypotension, shock, pulmonary oedema, myocardial ischaemia or a…

…treatment. Diagnostic drainage in suspected purulent pericarditis, tuberculosis or malignancy. Tamponade is a clinical diagnosis supported by echocardiography: Finding Comment : : Hypotension, distended neck veins, muffled…

…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…

…presence of myocardial necrosis. NSTEMI is confirmed by a typical rise and/or fall of high sensitivity cardiac troponin (hs cTn), with at least one…

…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…

…or anuria for at least 12 hours Use whichever criterion gives the higher stage. A patient can thus be stage 3 by urine output despite…

…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 : …

…While often asymptomatic, NSVT serves as a critical marker of arrhythmogenic risk, particularly in the setting of ischemic heart disease or reduced left ventricular ejection…

Cardiology Clinical medicine Introduction Cardiovascular disease becomes increasingly prevalent with advancing age, while its clinical expression and management become progressively more complex. Older adults, often…

…of cervical spine injury, in which scenario head tilt chin lift should only be used if other methods fail to open the airway. Figure 1…

…involvement should be considered when inferior infarction is accompanied by disproportionate systemic venous congestion, hypotension, or evidence of low output despite relatively limited elevation of…

…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…

…followed by compression. Infection in the skin overlying the puncture site. Previous pelvic irradiation on the intended side (yields fibrotic, unrepresentative marrow — choose the other…

…and other arrhythmias or conduction abnormalities. CKD also worsens the prognosis of established CVD. Mechanisms linking CKD to cardiovascular disease The association is mediated by…

…iFR / RFR / Pd Pa / dPR) Resting Pd/Pa during the diastolic “wave free period” (iFR) or the lowest ratio across the full cardiac cycle (RFR)…

…the aim should be a calm, mildly somnolent but rousable patient, while ventilation, circulation and underlying disease are monitored [3]. The management of complicated withdrawal…

…in treatment failure or in ongoing massive potassium release. In cardiac arrest with suspected hyperkalaemia, advanced life support is followed while the hyperkalaemia is treated…

…Insulin component Function Who needs it : : : Basal insulin (intermediate or long acting) Covers fasting glucose production Everyone with type 1 diabetes, always, including while fasting…

…characterized by reduced physiological reserve and increased vulnerability to adverse outcomes. It is dynamic and may improve or worsen with illness, treatment, or other interventions…

…fill the ventricles with blood (increased ventricular filling). Persons with premature beats might perceive this as palpitations, because of the stronger ventricular contractions caused by…

…cardiac cycle (see R on T phenomenon). While commotio cordis is caused by trauma to the chest, it is managed as a non traumatic cardiac…

…criterion in a column. Clinical deterioration or a poor response to treatment carries more weight than a single apparently reassuring measurement. Finding Moderate attack Acute…

…incompatible infusions. Haemodialysis, plasmapheresis or other extracorporeal therapy (requires a large bore dialysis catheter, not an ordinary triple lumen catheter). Measurement of central venous pressure…

…as the heart rate divided by the systolic blood pressure. A value of around 0.9 to 1.0 or higher in an adult trauma…

…or in those taking potassium supplements. When managing albuminuria or CKD, the serum creatinine and potassium should be monitored while increasing to the maximum tolerated…

…but hypertensive home or ambulatory pressure. Office measurements provide only a limited representation of usual blood pressure and may be biased by the clinical environment…

…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…

…blood contact. An alcohol or chlorhexidine swab. Let the skin dry completely before inserting the needle — alcohol carried in with the needle stings. Needles of…

…Reference ranges are statistical: by definition they encompass 95 % of a healthy reference population, which means that one healthy value in twenty falls outside them …

…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…

…or several mechanisms acting simultaneously. Acute myocardial infarction Acute myocardial infarction requires: Acute myocardial injury, demonstrated by a rise and/or fall in cardiac troponin…

…meal or with continued glucose administration adapted to the cause. 8. Identify drugs, renal failure, alcohol, a missed meal, physical activity and any other precipitating…

…Components of the HEMORR₂HAGES Score The acronym HEMORR₂HAGES represents the following parameters: H epatic or renal disease (1 point) E thanol abuse (1 point) M…

…Patients may obtain relief by sitting forward. Other symptoms depend on the extent of reduction in cardiac output and arterial pressure and may include: Chest…

…initial STEMI management. The principal acute complications fall into two broad categories: Electrical complications , particularly ventricular arrhythmias. Mechanical or pump failure complications , including heart failure…

…recommended by our professor of cardiology. It is often marketed as being the easiest book in the field, and readers are apparently appealed by that…

…and/or fall in cTn with at least one value above the 99th percentile URL; and Clinical evidence of acute myocardial ischaemia , demonstrated by at…

…5. Repeat on the other leg. If the signal is uncertain or borderline, the fibular artery can also be sought anterior to the lateral malleolus…

…with inotropic and vasopressor effects, and they often need to be combined in order to optimise or correct the haemodynamics. Most agents exert both vasopressor…

…started in an opioid naive patient, or when a conversion between drugs is made without reduction for incomplete cross tolerance. Indications Acute severe nociceptive pain…

…have other mechanisms of myocardial ischaemia and necrosis. Unstable angina (UA) represents myocardial ischaemia without demonstrable acute cardiomyocyte injury or necrosis. It is characterized by…

…With the following substances charcoal is ineffective and management is instead governed by the antidote, supportive treatment or dialysis: Group Examples : : Metals and salts Iron…

…movement; those that fail usually do so because the patient tenses up with pain, or because the operator pulls harder rather than more slowly. The…

…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…

…serious arrhythmia or acute heart failure. Routine opening of a persistently occluded infarct related artery in a stable and asymptomatic patient is by contrast not…

…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…

…is wrong to assume that hyperactive delirium is always detected, or that hypoactive delirium always carries the worst prognosis in every population. Hypoactive delirium is…

…or respiratory compromise. Diuretic refractory or diuretic intolerant ascites, as recurrent treatment. Contraindications There are in practice no absolute contraindications; suspected spontaneous bacterial peritonitis carries…

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

…was sutured over without being found. Indications A traumatic wound that gapes and cannot be expected to heal with good function or cosmesis without apposition…

…ejection fraction (HFmrEF) is a clinical syndrome defined by the combination of symptoms and/or signs of heart failure and a left ventricular ejection fraction…

…electronic cigarettes or other inhaled products. Readiness to attempt cessation. Depression, schizophrenia, schizoaffective disorder, HIV infection or other circumstances that may affect cessation or treatment…

…cause apnea or hypoventilation. Respiratory conditions : Tension pneumothorax Drowning Airway obstruction Hanging Pneumonia High altitude sickness Aspiration Chronic obstructive pulmonary disease (COPD) Bronchospasm (asthma) Other …

CPR Sepsis induced cardiac arrest Sepsis is a life threatening condition characterized by systemic inflammatory response syndrome (SIRS), disseminated intravascular coagulation (DIC), and hypoperfusion manifesting…

…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…