…antibiotics, fluid and lactate measurement. A meta analysis of emergency department alert systems found an association with lower mortality, but most of the evidence was…

…techniques should be pursued. Heated intravenous fluids (crystalloids). Heated and moistened oxygen. Warm covers. Heat fan. Remove any cold or damp textiles. Administer cardiopulmonary resuscitation…

…intravenous access, fluid and early contact with anaesthesia or intensive care Refractory anaphylaxis Persisting airway, respiratory or circulatory compromise despite two adequate intramuscular doses of…

…1. Is there obstruction to urine flow? 2. Is the patient hypovolaemic, adequately filled or fluid overloaded? 3. Is there, or is there approaching, an…

…balloon pump. Assessment of stroke volume variation as part of fluid management. Contraindications Infection, burn or trauma over the insertion site. Insufficient collateral circulation to…

…passive leg raising with an increase in stroke volume 10%, or inferior vena cava variability . In the absence of responsiveness, fluid does more harm than…

… 2. Is the hyponatraemia acute or chronic? Severe symptoms require immediate treatment with hypertonic sodium chloride, whether the hyponatraemia is acute or chronic. The aim…

…measured by means of Doppler (Figure 1). Figure 1. Calculating flow through a cylinder. Velocity Time Integral (VTI, stroke distance) The formula Q = a…

…Circulation Parameter Target Comment : : : MAP ≥ 65 mmHg 80–85 mmHg in chronic hypertension or when there are signs of inadequate perfusion Urine output 0.5…

…analyzing the time it takes for the sound to return to the transducer and thus calculating the distance to the structure that reflected the wave…

…imaging, the blood count or contact with the patient's own clinic delay empirical antibiotics [1]. A practical target: give the first dose of broad…

…together with echocardiographic signs of tamponade — not on how wide the rim of fluid looks. With ultrasound guidance, the point at which the fluid lies…

…Fluid in the syringe confirms the position. 4. Empty the joint as completely as possible — compress the bursa with your hand to press the remaining…

…Heart failure, pulmonary oedema and other conditions with a high risk of fluid overload — a relative contraindication requiring invasive monitoring and slower administration. Significant metabolic…

…sampling, but does not by itself identify the cause. The result must always be weighed together with the clinical picture, medication, fluid balance, renal function…

…Confirm at least 2–3 cm of free fluid depth with no bowel in the path of the needle and measure the skin to peritoneum…

…life threatening clinical syndrome in which increased intrapericardial pressure compresses the heart and impairs ventricular filling. It generally results from accumulation of pericardial fluid, blood…

…by the fluid. Video source.gif). ECG changes caused by pericardial effusion and cardiac tamponade Small amounts of pericardial effusion may not cause any ECG…

…great vessels are contained (Figure 1). The pericardial sac encloses the pericardial cavity which contains pericardial fluid. Numerous conditions may cause inflammation in the pericardium…

…Local anaesthesia: lidocaine 10 mg/mL with adrenaline (epinephrine). Syringe, 27 G and 21 G needles. Irrigation fluid (NaCl 9 mg/mL) and a 20…

…Peptic ulcer A proton pump inhibitor with concomitant NSAID use or a history of ulcer, not routinely Infection Consider Pneumocystis prophylaxis with high doses over…

…hours. Never irrigate and never instil fluid onto a battery — the moisture drives the reaction. The battery must come out immediately, with a hook, forceps…

…the tourniquet 10–15 cm proximal to the intended puncture site, let the arm hang, ask the patient to pump with the hand, and pa

…the lung and the fluid level. 2. Choose a point with at least 15 mm depth of fluid throughout the respiratory cycle and where the…

…around the clock for health care professionals. Contact the centre early in serious, unusual or unclear poisoning, with modified release preparations, mixed poisoning, pregnancy, children…

…mmHg for 15 minutes, or a need for a vasopressor), obstructive shock or cardiac arrest with suspected pulmonary embolism. Urgent bedside echocardiography, looking for right…

…with mild to moderate heart failure, kidney or liver disease, especially when combined with diuretics (risk of fluid retention and impaired kidney function). Patients with…

…CKD). These agents interfere with the renin angiotensin aldosterone system (RAAS) by inhibiting the enzyme responsible for the conversion of angiotensin I to angiotensin II…

…effects on the cardiovascular system. Acute exposure produces transient haemodynamic and myocardial effects, whereas sustained heavy consumption is associated with hypertension, coronary artery disease, arrhythmias…

…If the patient presents with hypotension or has a lactate level exceeding 4 mmol/l, commence an intravenous fluid resuscitation using a crystalloid solution at…

…cause tamponade. Tamponade with swinging heart of the pericardium. Source. Rapid diagnosis of cardiac tamponade is possible via bedside echocardiography. This reveals pericardial fluid, suggesting…

…vessels. The visceral layer consists of mesothelian cells, collagen and elastin and is fused with the myocardium. At the departures of the larger vessels, the…

…below apply to adults unless otherwise stated, and paediatric doses are given per kilogram with the stated maximum. Always check against the local guideline and…

…the emergency situation. Consider alternatives when: Intubation is not consistent with the treatment plan — check any decision to limit treatment when time allows. There is…

…1. Visual acuity in each eye separately , with the patient's usual glasses and then through a pinhole. This is done before any drops. 2…

…system, lukewarm fluid (tap water for adults, isotonic saline for children), a collecting vessel, a bite block, and powerful suction with wide bore tubing. Working…

…flaccida → signs of fluid (a level, bubbles, retraction or bulging). 6. Where needed, pneumatic otoscopy: a slight change of pressure with the bulb shows…

…a cold periphery and delayed capillary refill confusion, drowsiness or syncope oliguria a rising lactate or metabolic acidosis repeated fresh haematemesis haematochezia in combination with…

…With a glass injury: consider radiography, since glass is usually visible on plain films. Irrigation fluid: a copious volume of drinking quality tap water or…

…risk of type 2 diabetes, metabolic syndrome and specific cancers. BMI and cardiovascular outcomes High BMI is associated with several health conditions: Type 2 diabetes…

…Pharmacology & dosing Definition and pathophysiology Heart failure is a clinical syndrome in which the heart cannot provide blood flow commensurate with the body’s requirements…

…contrast is considered causally responsible. This distinction is important because AKI after a contrast study frequently occurs in patients with several simultaneous renal insults. Infection…

…as well as related biomechanical and fluid dynamic factors. Increased thickness and length, and a more proximal vessel location, are associated with greater clinical risk…

…or intraosseous fluid bolus, beginning with 500 ml of normal saline over 5 10 minutes, adjusting based on response. If hypotension persists despite fluid and…

…either within or outside the hospital, prompt communication with an obstetrician and neonatologist is critical. Cardiopulmonary resuscitation (CPR) should generally adhere to the standard adult…

…a physical medium. This medium may consist of any matter, e.g air, water, metal, or tissue and fluids in the human body. Sound waves…

…waves. The transducer is held with one hand and its position and angle are adjusted to send ultrasound waves through structures to be visualized. Ultrasound…

…Cold environment. Passive cooling. Cold oral fluids. Heat syncope Discomfort, anxiety, dizziness, syncope. Cold environment. Cold intravenous fluids (1 2 L crystalloid, with rate 500…

…by a repolarization (recovery). The action potential occurs in all cardiac cells but its appearance varies depending on cell type. During de and repolarization ions…

…Contraindications Asthma and COPD. Adenosine has caused mild to moderate exacerbation of asthma symptoms. Adenosine should be used with caution in patients with obstructive lung…

…any given instant during the cardiac cycle, all ECG leads analyze the same electrical events but from different angles. This means that ECG leads with…