…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 …

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

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

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

…choose the more patent one. Ask the patient about a previous nasal fracture or unilateral nasal obstruction. 2. Measure the depth of insertion by laying…

…the presumed cause of bleeding, and how the products are to be delivered. 2. Designate a team leader and one person responsible for recording the…

…and assess the effect before the next one is given. The serious incidents almost always arise when the principle of titration is abandoned — when a…

…hard to find in older women. Two things separate the safe catheterisation from the harmful one: never forcing against resistance, and never catheterising urethrally when…

…than one who is taken by surprise. Procedure 1. Connect the patient to the 12 lead ECG as usual and record a resting ECG of…

…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…

…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…

…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…

Procedurer Benign paroxysmal positional vertigo is the commonest cause of vertigo in primary care and one of the few diagnoses that can be cured on…

…the highest risk of experiencing malign ventricular arrhythmias. Brugada syndrome is hereditary with an autosomal dominant inheritance pattern, meaning that only one mutated gene is…

…Sudden cardiac death (SCD) remains one of the most intractable challenges in clinical cardiology. Hundreds of thousands of arrhythmic deaths occur annually in the United…

…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…

…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…

…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…

…a high probability of unstable angina (UA), and patients whose initial findings are less definitive. The defining electrocardiographic feature is the absence of persistent ST…

…Presentation and Symptoms The characteristic symptom prompting activation of the STEMI pathway is ischaemic type chest discomfort, although dyspnoea may also be a presenting feature…

…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…

…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…

…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…

…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…

…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…