…prediction of sudden cardiac arrest. The constraint does not lie in therapy: implantable cardioverter defibrillators (ICDs) are highly effective, terminating well over 99% of the…

…digital block Anaesthetise from the dorsal aspect, one injection medial and one lateral to the base of the phalanx, 2–3 mL on each side…

…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…

…and in patients with diabetes or renal failure the index may be falsely normal because of medial sclerosis — in that case add toe pressure measurement…

…particularly high risk and should influence the urgency of management: Recurrent or ongoing chest pain despite medical treatment Acute heart failure presumed to result from…

…extent of myocardial injury is strongly influenced by total ischaemic time. This interval includes: The time from symptom onset to recognition and seeking medical assistance…

…daily or an equivalent dose of another statin. Approximately 45% of participants had type 2 diabetes. Over a median follow up of 40.6 months…

…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 …

…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…

…times the flow of a fine needle, and collapsed veins mean that the fine needle is in addition the only one that will go in…

…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…

…major haemorrhage protocol early. Protocols improve above all the logistics, the communication and the simultaneous delivery of red cells, plasma and platelets. Observational data from…

…The contralateral side of the septum already cauterised — bilateral cautery carries a risk of perforation Anterior packing: Suspected base of skull fracture or a significant…

…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…

…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…

…the visual acuity before anything else is done. The second most important is to look for signs of perforation — Seidel's sign, an irregular pupil…

…it is the shape of the tip and the technique that matter, not the calibre; choose instead the smallest size that will do the job…

…rather than by negative remodelling. Pathophysiology Neointimal hyperplasia The principal mechanism of ISR is neointimal hyperplasia following vessel wall injury. PCI and stent implantation produce…

…of acute myocardial infarction Procedural and mechanical Stent underexpansion, incomplete wall apposition, residual inflow or outflow disease, edge dissection, overlapping stents, crush technique, stent fracture…

…be established. Nasopharyngeal airways may cause complications in patients with skull fractures (risk of intracranial malposition of the tube) or coagulopathy (risk of bleeding). An…

…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…

…intramural haematoma. Spontaneous coronary artery dissection is defined as spontaneous dissection of the coronary artery wall with accumulation of blood within the false lumen, which…

…The patient sits upright on the couch, far enough forward that the head will extend beyond the end of the couch when laid down. 2…

…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…

…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…

…beds. Malignant hypertension represents an extreme form in which acute microvascular injury occurs, classically involving fibrinoid necrosis of small arteries in the kidneys, retina, 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…

…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…