…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…

…on without tension Tepid water, plastic gloves, plaster scissors, cast saw, protective sheeting Hot water gives faster setting and more heat production — a risk of…

…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…

…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 …

…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…

…is applied to the lower third of the nose, the soft part , and held continuously for at least 10 minutes without letting go to look…

…Contraindications Ongoing respiratory depression, or untreated severe respiratory failure without the possibility of monitoring. Paralytic ileus and suspected obstructive ileus (an opioid can be given…

…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…

…body reaching the stroma or deeper. The absence of a slit lamp — the cornea should not be instrumented without magnification. With a suspected chemical injury…

…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…

…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…

…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…

…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…

…Is the patient stable without high risk characteristics and therefore potentially suitable for a selective invasive approach? Is the clinical likelihood of true NSTE ACS…

…stable, asymptomatic patients without severe ischaemia. Evaluation and Physical Examination The initial evaluation should be structured to establish a working diagnosis of STEMI rapidly, identify…

…may nevertheless be diagnosed without proteinuria when clinical symptoms or laboratory abnormalities indicate end organ injury. Eclampsia is the occurrence of new onset seizures or…

…include fixed coronary atherosclerosis without plaque rupture, coronary artery spasm, coronary microvascular dysfunction (encompassing endothelial dysfunction, smooth muscle cell dysfunction, and dysregulation of sympathetic innervation)…

…in three minutes, without drugs . The diagnosis rests on the history, a positive Dix–Hallpike test and the absence of other neurological findings. The treatment…

…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…

…I, V5, and V6 (though a narrow Q wave may exist in aVL without myocardial pathology) [3] Absence of Q waves in I, V5, and…

…Prevention of recurrence after a healed venous ulcer. After deep vein thrombosis with post thrombotic syndrome. Differential diagnosis Feature Venous ulcer Arterial ulcer Diabetic foot…

…abrupt deterioration in renal function. By contrast, hypertensive urgency describes severe hypertension without clinical evidence of acute, ongoing target organ damage. Although BP reduction is…

…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…

…skeletal muscle, a pharmacological feature that may limit muscle related toxicity despite bempedoic acid acting within the same broad cholesterol synthesis pathway as statins. The…

…disorder may manifest with any of the following symptoms: Syncope, pre syncope Ventricular tachycardia Ventricular fibrillation Cardiac arrest with or without sudden cardiac death Hence…

…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…