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

…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 …

…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…

…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…

…access (absolute, for the bone in question): A fracture of the bone to be punctured, or a major injury proximal to the puncture site. A…

…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…

…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…

…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…

…6. Introduce the electrode along the floor of the nose, parallel with the palate and straight backwards , not upwards towards the bridge of the nose…

…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…

…where the figure corresponds to the circumference in millimetres — a Ch 16 therefore has a diameter of about 5 mm. Indication Size Comment : : : Clear urine…

…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…

…thrust is preferred if there is suspicion of cervical spine injury, in which scenario head tilt chin lift should only be used if other methods…

…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…

…reversal of the nystagmus is common. 6. Repeat on the left side. A positive test in the posterior canal is characterised by: A latency of…

…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…

…130 msec in females , along with slurring or notching of the mid QRS in at least two left facing leads [7]. These stricter parameters correlate…

…deep vein thrombosis with post thrombotic syndrome. Differential diagnosis Feature Venous ulcer Arterial ulcer Diabetic foot ulcer : : : : Site Gaiter area, above the medial malleolus Toes…

…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…

…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…

…resistant to resolution. Known predictors of cardiac arrest The only risk biomarker in genuinely widespread use is left ventricular ejection fraction (LVEF), measured by echocardiography…