…when the arm is flexed. The dorsum of the hand is suitable for finer cannulae. Avoid the lower limb in adults. In shock with collapsed…

…the communication and the simultaneous delivery of red cells, plasma and platelets. Observational data from trauma suggest a lower overall mortality after such protocols are…

…is given. The serious incidents almost always arise when the principle of titration is abandoned — when a fixed dose is given without assessment, when a…

…ISR remains the most frequent cause of PCI failure, despite its substantially lower incidence with drug eluting stents (DES) than with bare metal stents (BMS…

…Procedure Step 1 — compression Have the patient blow out the clot. The pinch is applied to the lower third of the nose, the soft part …

…3. Ocular movements in all directions; pain on upward gaze may suggest an orbital floor fracture. 4. Topical anaesthesia into the lower fornix. 5. Evert…

…treat (NNT) for the ACLS specific interventions is much higher or uncertain, meaning that the efficacy of these interventions is much lower or uncertain. Indeed…

…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…

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

…LBBB) Electrocardiographic Criteria and Characteristics Left bundle branch block is characterized by a significant reorganization of the activation and recovery patterns within the left ventricle…

…inhibitor crisis, cocaine intoxication, or other sympathomimetic exposure, including methamphetamine. Abrupt withdrawal of antihypertensive medication, particularly clonidine, can also precipitate a hypertensive crisis. Pregnancy Hypertensive…

…LDL receptor. They lower LDL C by approximately 50–60%, including in patients receiving background statin therapy and in those unable to tolerate statins, provided…

…from those in Brugada syndrome and the risk of ventricular arrhythmias and sudden cardiac death is considerably lower than the risk among patients with Brugada…

…was approximately 19.1%. The drug also lowers hsCRP. In a population of individuals unable or unwilling to take statins, bempedoic acid 180 mg daily…

…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…

…becomes and the greater the risk of chondral and neurovascular injury. Aim for reduction within a few hours. Contraindications A fracture dislocation requiring operative treatment …

…as an open fracture. The anatomy of the nail apparatus The terminology is hard to follow without a picture, and several of the steps below…

…dislocation. Immobilisation of a ligament injury, a tendon injury, or after suturing over a joint. Pain relief and stabilisation for transfer in a suspected fracture…

…stricture or a known diverticulum Relative Recent nasal or pharyngeal surgery Signs that should raise the suspicion of a base of skull fracture: periorbital bruising…

…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…

…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…

…angiogenic signalling. A central biochemical feature is an imbalance between antiangiogenic and angiogenic factors. Placental production of soluble fms like tyrosine kinase 1 increases, whereas…

…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…

…the choice of dressing but the ankle brachial index before the first bandage is applied . Indications Venous leg ulcer — about 70% of all leg ulcers…

…the difference in R wave amplitude, note the slurred terminal portion of the R wave in the high risk morphology, which replaces the sharp negative…