…diagnosis Feature Venous ulcer Arterial ulcer Diabetic foot ulcer : : : : Site Gaiter area, above the medial malleolus Toes, heel, lateral malleolus, pressure points Beneath the metatarsal…

…class and the airway beforehand. Procedure Anterior shoulder dislocation The commonest of all dislocations. There is a hollow beneath the acromion, the arm is held…

…to return of bowel function without reducing the risk of complications. Contraindications Type Condition : : Absolute Suspected base of skull fracture or a marked midfacial fracture …

…Anterior packing: Suspected base of skull fracture or a significant midfacial or nasal fracture (absolute). An unsecured airway or haemodynamic instability — stabilise the patient first…

…surgery of the nose, pharynx or oesophagus. Marked nausea, anxiety or communication difficulties that prevent the patient from cooperating. Suspected base of skull fracture or…

…often missed. On medical and geriatric wards a substantial proportion of older patients are affected, and the incidence is particularly high after hip fracture, major…

…The absence of a slit lamp — the cornea should not be instrumented without magnification. With a suspected chemical injury the priorities are reversed: irrigate first …

…the possibility of monitoring. Paralytic ileus and suspected obstructive ileus (an opioid can be given for the pain, but the effect on the bowel must…

…impairment or a large residual volume. A need for accurate measurement of urine output in a critically ill patient. Perioperatively and postoperatively in longer procedures…

…crush technique, stent fracture or collapse Lesion specific angiographic features Residual dissection at a stent margin, impaired flow into or out of the stent, stent…

…meaning that the efficacy of these interventions is much lower or uncertain. Indeed, the greatest opportunities for survival exist during the first few minutes from…

…the first hour, making rapid recognition, defibrillation capability and expedited reperfusion central to survival. Clinical Presentation and Symptoms The characteristic symptom prompting activation of the…

…morbidity and mortality. Their incidence has increased in parallel with older maternal age at first childbirth and the rising prevalence of obesity. Gestational hypertension is…

…dislodgement, lead fracture or inadequate myocardial contact. It may also be due to the low amplitude (voltage) of the potentials generated by activated myocardium. Functional…

…is the lunula. The matrix horns are the lateral extensions of the matrix, reaching out to the sides beneath the nail folds. It is these…

…protects against the edges of the cast Padding The wadding that protects the skin and the bony prominences Plaster bandages and plaster slabs (calcium sulfate…

…swelling. A vein suspected of thrombosis or previously thrombophlebitic. Intraosseous access (absolute, for the bone in question): A fracture of the bone to be punctured…

…Secure large bore access, or rapid central access, but do not delay transfusion or control of the bleeding in order to obtain a central venous…

…Stent fracture or collapse Residual edge dissection Incomplete lesion preparation Persistent stenosis within the treated segment Mechanical factors are particularly important because correction of the…

…revascularization, while avoiding unnecessary procedural complications and bleeding in those at lower risk or in whom the hazards of revascularization outweigh its potential benefit. A…

…plaque disruption is not a feature of Type 2 MI. The pathophysiology of Type 2 MI is fundamentally distinct from that of Type 1 MI…

…A single central feature is enough to proceed with urgent investigation , and a normal CT of the brain does not exclude an infarction in the…

…leads generally indicates very severe ischemia [15]. A key distinguishing feature of ischemic ST elevation is the presence of prominent reciprocal ST depression [4]. Furthermore…

…leads [7]. These stricter parameters correlate more closely with abnormal LV mechanical function and the potential benefit of resynchronization pacemaker therapy [7]. R Wave Peak…

…follow up Main risk of management Overtreatment may impair autoregulation and cause ischemia Acute rapid reduction may cause harm without prognostic benefit Clinical Presentation and…

…Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a hepatic protein that regulates the availability of the low density lipoprotein receptor (LDL receptor) on hepatocytes…

…Clinical evidence for cardiovascular benefit CLEAR Outcomes CLEAR Outcomes was a randomized, double blind, placebo controlled study of 13,970 patients at high cardiovascular risk…

…the most distinguishing feature was the characteristic ST segment elevations in leads V1–V3. Prevalence and genetics of Brugada syndrome The prevalence of Brugada syndrome…

…99% of the ventricular arrhythmias they detect. It lies instead in patient selection. Because implantation entails appreciable cost and procedural risk, the risk benefit balance…