…were included. At 30 days, 20% of those in the extracorporeal CPR group and 16% in the conventional CPR group had a favorable neurologic outcome…

…or treatment with another adenosine diphosphate (ADP) receptor inhibitor for patients who had coronary syndrome and are at high risk of developing a new event…

…Duration of smoking and cumulative exposure. Previous quit attempts and their duration. Triggers for smoking and anticipated barriers to cessation. Exposure to second hand smoke…

…waves. The transducer is held with one hand and its position and angle are adjusted to send ultrasound waves through structures to be visualized. Ultrasound…

…young, old, healthy and diseased individuals. For example, roughly 90% of males aged <30 years display concave ST segment elevations in leads V2–V3. This…

…wrong move — in the hand, in the medial triangle of the face or perianally. Indications Fluctuant, tender, erythematous and indurated swelling in the skin or…

…mask and cap. Lidocaine 10 mg/mL for local anaesthesia in the awake patient — the anaesthetic also improves the chance of success by counteracting vascular…

…poorer absorption. Injection into an arm with a dialysis fistula. Preparation and equipment Hand disinfection; gloves where there is a risk of blood contact. An…

…to its depth, and has not been assessed for tendon and nerve injury will heal badly however neatly the suture is placed. The commonest cause…

…exploring electrode (albeit with somewhat varying angles) and therefore displays a positive P wave throughout. Figure 2 (above) does not show that the P wave…

…transmural ischemia. On the other hand, leads V1–V3 (occasionally V4) may detect the injury currents and present them as ST segment depressions. These depressions…

…In STE ACS, on the other hand, the ST segment depressions are secondary findings and the primary findings are the ST segment elevations. As explained…

…for example aphasia, hemianopia or hand paresis in a person of working age Blood pressure Measure initially in both arms if this does not delay…

…rheumatoid arthritis, ankylosing spondylitis MACOCHA is validated for the intensive care patient and totals 12 points: Mallampati III–IV (5 points), obstructive sleep apnoea syndrome…

…injury is to measure and document the visual acuity before anything else is done. The second most important is to look for signs of perforation…

…and powerful suction with wide bore tubing. Working suction, oxygen and complete equipment for intubation and ventilation must be to hand before the lavage begins…

…for palpation guided aspiration. Press the fluid from the medial towards the lateral side with your free hand. The needle is inserted directed medially and…

…a visor. Suction must be out and working before you begin. Inform the patient and agree a hand signal for a pause. Position the patient…

…hard plug. Have the patient lie with the ear uppermost for 5 minutes after instillation. Procedure Otoscopy 1. Inspect the outer ear, the tragus and…

…hand. Sterile gown and gloves, chlorhexidine in alcohol 5 mg/mL, a large fenestrated drape. Lidocaine 10 mg/mL for local anaesthesia, 25 G and…

…but the cannula kinks when the arm is flexed. The dorsum of the hand is suitable for finer cannulae. Avoid the lower limb in adults…

…The thresholds for the INR and the platelet count vary between regions. Common practice is correction at an INR above 1.5 and a platelet…

…and for immunofluorescence Michel's medium or saline according to local procedure. Photograph and draw in the site before the local anaesthetic is given — the…

…and among those who did, only a minority had a reduced value — the majority of sudden cardiac deaths occur in patients with preserved LVEF, for…

…of atrial fibrillation correlates strongly with age. Approximately 10% of individuals aged 80 years and above have atrial fibrillation, whereas the arrhythmia is unusual among…

…blood flow. Acute coronary syndromes are subdivided into STE ACS and NSTE ACS . STE ACS is the acronym for ST Elevation Acute Coronary Syndrome . All…

…the elderly also tend to have more atherosclerosis (both in frequency and severity) which may compensate for the inability to reach their maximal heart rate…

…activity. This is partly due to the rise of cardiac imaging and invasive electrophysiological methods which allow for detailed in vivo studies of arrhythmias. However…

…on the other hand, is caused by a complete coronary artery occlusion, which results in the complete stop of blood flow and thus more extensive…

…situations, sinus arrest/pause should be considered abnormal, and the following differential diagnoses are at hand: Sinus node dysfunction. Side effects of drugs (diltiazem, verapamil…

…transmural ischemia. On the other hand, leads V1–V3 (occasionally V4) may detect the injury currents and present them as ST segment depressions. These depressions…

…in several views in order to assess the reliability and reproducibility of the measurements. The parasternal and apical windows are obtained with the patient positioned…

…the diagnosis can often be established by examining fewer leads. On the other hand, for the purpose of diagnosing morphological changes (e.g. myocardial ischemia…

…confused J points, notches and slurs I once had the privilige of attending a lecture given by professor Salim Yusuf of McMaster University. Professor Yusuf…

…a complete one. Contact the urologist or the surgeon on call for urethrography and suprapubic drainage. Preparation and equipment A sterile catheterisation pack, sterile gloves…

…cardiac arrest is the mechanism of death for about half of all individuals with heart failure ( Packer et al ) and 30% of people with diabetes…

…with HEMORR₂HAGES and ATRIA, respectively (Apostolakis et al). ATRIA Score: The same study found that the ATRIA score had a lower predictive performance for major…

…and repeat revascularization. For example, in the SYNTAX trial, patients with high scores had significantly higher mortality and MACE rates compared to those with low…

…impaired autonomic compensation limits tolerability. Evidence Base and Its Limitations Few adults aged 85 years or older have been included in randomized controlled trials. Moreover…

…cardiopulmonary conditions account for approximately 5% of presentations in some populations. Despite this relatively low prevalence, missed myocardial infarction remains consequential, and historically 2–6…

…drug comprises both d and l isomers, which share similar efficacy in prolonging repolarization. However, the l isomer is responsible for virtually all of the…

…pupillary reflex for predicting a poor neurological outcome was 68.8%. This implies that approximately one third of the patients who ultimately had a favorable…

…with greater ST elevation in aVR had higher crude in hospital and 6 month mortality (up to 18% at 6 months for 1 mm elevation…

…is not a test for BPPV. It is used in the acute vestibular syndrome — continuous vertigo with spontaneous nystagmus, nausea and difficulty walking that has…

…pressures, for example severe ARDS, marked obesity or a stiff chest wall. Glottic or subglottic obstruction — the mask sits above the obstruction and solves nothing…

…The anatomy of the nail apparatus The terminology is hard to follow without a picture, and several of the steps below refer to structures that…

…points — follow the local instructions, but where the response is equivocal both are valuable. 7. Observe the patient throughout the test and for 15 minutes

…al . Brugada syndrome was identified in the early 1990s and early repolarization was identified as a risk factor for sudden cardiac arrest in 2008 (1…

…in both LDL C and hsCRP. Individual responses vary, making biochemical reassessment after treatment initiation or intensification necessary. Clinical evidence for cardiovascular benefit CLEAR Outcomes…

…pericardial collection with initially limited symptoms because the pericardium has had time to adapt. Hypotension and muffled heart sounds are important when present but are…

…levels who had underlying cardiovascular disease, of which 69.4% died. Guo et al also report a significant association between troponin T levels and C…

…is currently witnessing a paradigm shift. For decades, the management of type 2 diabetes mellitus (T2DM) and obesity was siloed, with clinicians focusing primarily on…

…For adults aged 40–75 years without diabetes and with LDL C between 70 and 189 mg/dL, 10 year risk of a first hard…

…This helps explain the neurological manifestations of preeclampsia and the potential for stroke even at blood pressure levels that might otherwise be considered only moderately…

…management, key aspects of pathophysiology and discussions on differential diagnoses for each condition. Moreover, most books included very few real world examples of the conditions…

…and defibrillation according to adult recommendations. Electrode pads should be positioned as standard, and defibrillation energy levels should remain consistent with those used for non…

…heavy, and the person is very tired. 18 19 Extremely hard exertion For most people this is the most strenuous exercise they have ever experienced…

…block (LBBB) in patients with acute coronary syndromes (ACS) For many years, European and North American guidelines recommended managing patients with symptoms of myocardial ischem

…was first descried in 1991 in Japan and the authors termed it takotsubo , which is the Japanese word for a kind of octopus trap (the…