…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…

…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…

…Suspected base of skull fracture or marked coagulopathy argues against the nasal route; the oral route may then be considered. Preparation and equipment A 12…

…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…

…cases of malfunction are associated with the electronics in the pulse generator or dislodgement or fracture of the leads. External causes are less common and…

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

…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…

…cannula in a large vein gives many times the flow of a fine needle, and collapsed veins mean that the fine needle is in addition…

…uncontrolled source of bleeding. Minimise the time to surgery, endoscopy, an obstetric procedure or angiographic intervention. Summon anaesthesia, the operating specialty, the blood bank and…

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

…hip fracture, major surgery and intensive care [1,2]. The condition is associated with falls, aspiration, pressure sores, loss of function, longer length of stay…

…pressure measured, or be palpated. Indications A sensation of something in the eye, watering, photophobia and redness after working with a grinder, a drill, a…

…catheter is not easier to pass. With a difficult passage it is the shape of the tip and the technique that matter, not the calibre…

…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…

…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…

…diagnosis of NSTE ACS and a high probability of unstable angina (UA), and patients whose initial findings are less definitive. The defining electrocardiographic feature is…

…activation of the STEMI pathway is ischaemic type chest discomfort, although dyspnoea may also be a presenting feature. The source material emphasizes that patients and…

…mechanism of preeclampsia remains incompletely established. Proposed contributors include chronic uteroplacental ischaemia, an exaggerated maternal inflammatory response, and disturbed angiogenic signalling. A central biochemical feature…

…oxygen supply and demand, which is not related to acute coronary atherothrombosis. By definition, acute atherothrombotic plaque disruption is not a feature of Type 2…

…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…

…Diagnosis of ST Elevation Several nonischemic conditions can produce ST segment elevations that mimic acute myocardial infarction. Acute pericarditis is a primary differential diagnosis and…

…The following table summarizes the common diagnostic criteria for complete and incomplete LBBB: Feature Complete LBBB Incomplete LBBB QRS Duration $\ge 120$ msec [3…

…arterial insufficiency can cause necrosis and, in the worst case, amputation. The decisive step is therefore not the choice of dressing but the ankle brachial…

…In patients with HFpEF, acute hypertension is a frequent trigger of decompensation and may produce abrupt pulmonary oedema, sometimes requiring non invasive ventilation or intubation…

…target is not achieved. Addition of a PCSK9 inhibitor when the target remains unmet despite maximally tolerated statin therapy and ezetimibe. For patients with a…

…a population of individuals unable or unwilling to take statins, bempedoic acid 180 mg daily produced approximately 21% reductions in both LDL C and hsCRP…

…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…

…effective, terminating well over 99% of the ventricular arrhythmias they detect. It lies instead in patient selection. Because implantation entails appreciable cost and procedural risk…