…chemistry & laboratory medicine Emergency medicine Myocardial ischemia and infarction Definition and Pathophysiological Basis High sensitivity cardiac troponin (hs cTn) assays detect circulating troponin released from…

…therefore requires individualized balancing of ischemic and bleeding hazards. High bleeding risk (HBR) should be assessed in a structured manner. Within the ARC HBR framework…

…mg/dL) to reduce cardiovascular risk. 1. Assess Prior Treatment • No prior treatment, low dose, or low intensity lipid lowering therapy: • Start high potency, high…

Hydralazine Hydralazine is not preferred for hypertensive emergencies due to the high risk of reflex sympathetic stimulation. Drug Hydralazine Brand names Apresoline ®, Bidil ®…

…chemistry & laboratory medicine Definition and Pathophysiology Apolipoprotein B (apoB) and non high density lipoprotein cholesterol (non HDL C) are complementary measures of atherogenic lipoprotein burden…

…Mitral regurgitation Causes of mitral regurgitation The most common cause of mitral regurgitation in high income countries is age related degeneration of the valvular apparatus…

…cessation of prolonged and heavy alcohol intake. The condition can develop despite a measurable or high blood alcohol concentration, particularly in patients with marked tolerance…

…< 120 and < 80 Normal 120–129 and/or 80–84 High normal 130–139 and/or 85–89 Grade 1 hypertension 140–159…

…recovery. A patient who stops at a low workload with a fall in blood pressure is a high risk patient even with normal ST segments…

…see the table), a syringe of the correct size, a sharps bin. For vaccination: adrenaline 1 mg/mL, an antihistamine, oxygen, and the ability to…

…a high risk of hypoglycaemia 8–12 mmol/L The critically ill patient in intensive care According to the local protocol Avoid tight targets in…

…is incomplete: reduce the calculated equianalgesic dose by 25–50 per cent and titrate. At a high dose, in old age or in renal failure…

…disease Stage eGFR Description : : : G1 ≥ 90 Normal or high G2 60–89 Mildly reduced G3a 45–59 Mildly to moderately reduced G3b 30–44 Moderately…

…high risk of a new event. Treatment can be started without interruption as continuation treatment after the initial one year treatment with Ticagrelor 90 mg…

…of patients should undergo angiography within 24 hours, but high risk patients should be evaluated with angiography earlier. Guidelines recommend the use of validated risk…

…cardiac death: what the new Nature study shows Low risk (blue) versus high risk (red) ECG morphs in lead aVL (adapted from Obermeyer et al…

…commensurate with the body’s requirements, or can do so only at the expense of abnormally high filling pressures. The resulting haemodynamic congestion produces a…

…completely different. It took roughly 50 years for researchers to finally conclude that high cholesterol levels caused coronary artery disease and atherosclerosis in general. This…

…particularly among high risk patients. The strategy may, however, increase peri procedural complications and bleeding. Clinical presentation The available source material does not provide a…

…practice guidelines for emergency medicine (and prehospital medicine). This is high quality medical education simply. Life in the Fast Lane Australian site with one of…

…principal drugs identified in the source material are canagliflozin, dapagliflozin and empagliflozin; sotagliflozin is a related dual SGLT1/SGLT2 inhibitor. SGLT2 is a high capacity…

…world: What is the best ECG book? This question is far from trivial and the stakes are high; mastering ECG interpretation will frequently be a…

…the intensity of reflected sound waves. Structures with high echogenicity will reflect more ultrasound and appear brighter on the image. Structures with low echogenicity reflect…

…treatment, with a very low number needed to treat (NNT), indicating high effectiveness. Although BLS is primarily developed for out of hospital cardiac arrest (OHCA)…

…Respiratory conditions : Tension pneumothorax Drowning Airway obstruction Hanging Pneumonia High altitude sickness Aspiration Chronic obstructive pulmonary disease (COPD) Bronchospasm (asthma) Other : Coma Central hypoventilation syndromes…

…and hypoperfusion manifesting as hypotension. The high mortality associated with sepsis underscores the critical importance of timely and appropriate interventions. In patients presenting with concurrent…

…In principle, all causes of pericarditis can result in constrictive pericarditis. In high income countries, idiopathic pericarditis, radiation to the pericardium and surgical interventions are…

…Dipyridamole, Regadenoson : Should be avoided in patients with active bronchospasm, severe hypotension, or high degree AV block. Caffeine and other methylxanthines, which antagonize adenosine receptors…

…of cardiovascular disease. It has been the number one killer in Western and high income countries for more than half a century, causing approximately 20…

…and should be managed urgently. The risk of cardiogenic shock and cardiac arrest is high and pharmacological interventions are frequently futile. It is often necessary…

…relaxation should proceed rapidly and the ventricle should expand substantially. This requires that the myocardium has high compliance , a term used to describe myocardial elasticity…

…4. Take a full blood count, electrolytes, creatinine, glucose, high sensitivity troponin and, where needed, coagulation tests. Blood sampling must not delay reperfusion. 5. Give…

…coat hypertension: raised office blood pressure without organ damage. Suspected masked hypertension: normal office blood pressure but organ damage or high risk. Treatment resistant hypertension…

…60 mg once daily 30 mg once daily at eGFR 15 50 mL/min, weight ≤60 kg or concomitant P gp inhibitor Dabigatran 150 mg…

…respiratory disturbance, by contrast, develops over hours to days [1,2]. Six steps Step Question Practical interpretation : : : 1 Is the pH low or high? pH…

…Atelectasis and postoperative hypoxaemia. Hypoxaemic failure where high flow nasal oxygen is insufficient and the carbon dioxide is normal. Bilevel NIV: Acute exacerbation of COPD…

…wards a substantial proportion of older patients are affected, and the incidence is particularly high after hip fracture, major surgery and intensive care [1,2…

…three components: diabetes or hyperglycaemia, ketosis and metabolic acidosis. A very high glucose value is no longer required [1]. Diabetic ketoacidosis, DKA Hyperosmolar hyperglycaemic state…

…present). High voltage (excessive amplitudes) is present if the S wave in V1 or V2 + the R wave in V5 is 35 mm. Q waves…

…be secured. Preparation and equipment Edrophonium 10 mg/mL, 1 mL (named patient product — order well in advance). Atropine 0.5 mg for premedication, plus…

…at lower values if the rise is rapid, the patient has symptoms, or the clinical risk is high [1,2]. 1. Perform an ABCDE assessment…

…result. Overview of vasopressors and inotropes Vasoconstriction Vasodilatation Positive inotropy Phenylephrine Vasopressin Midodrine Noradrenaline Adrenaline, high dose Dopamine, high dose Adrenaline, low dose Dopamine, intermediate…

…completely. Relative contraindications: A high risk of aspiration: a non fasted patient, ileus, third trimester pregnancy, marked reflux. A need for high airway pressures, for…

…be palpable despite ischaemia ABI 0.9 < 0.9 Often falsely high Contraindications to compression The ankle brachial index measured with Doppler determines whether…

…cannot be established with spirometry alone, but is suspected when the FVC is low with a normal or high ratio. Reversibility: an increase in FEV₁…

…48 hours Profound neutropenia A neutrophil count below 0.1 × 10⁹/L An expected high risk course Neutropenia expected to last longer than 7 days…

…A high oxygen concentration washes nitrogen out of the pleural air and speeds resorption. Other conditions in which high flow oxygen is given irrespective of…

…clinical picture are sufficient for a treatment decision. Systemic thrombolysis is the first line treatment in high risk embolism, unless there is an absolute contraindication…

…surgeon. Dislocation of a native hip (as opposed to a prosthesis) — a high risk of avascular necrosis of the femoral head and of vascular injury…

…usually 500 mL as a rapid bolus, and a smaller bolus where the risk of fluid overload is high 0 to 30 min Clinical assessment…

…equipment A sterile catheterisation pack, sterile gloves, chlorhexidine solution 0.2 mg/mL or an equivalent cleansing solution, sterile gauze, sterile water for the balloon…

…suture material, scissors, dressings. Local anaesthesia Agent Onset Duration Comment : : : : Lidocaine 10 mg/mL Rapid 1–2 hours The standard choice Lidocaine 10 mg/mL…

…The cornerstone of LQTS management involves lifestyle modifications, pharmacotherapy, and, in high risk cases, device implantation. Beta blockers, particularly non selective agents like nadolol and…

…The cornerstone of LQTS management involves lifestyle modifications, pharmacotherapy, and, in high risk cases, device implantation. Beta blockers, particularly non selective agents like nadolol and…

…in women (3 points) Severe Renal Disease: Estimated glomerular filtration rate (eGFR) <30 mL/min or dialysis dependent (3 points) Age ≥75 years: (2 points)…

…BMI and cardiovascular outcomes High BMI is associated with several health conditions: Type 2 diabetes Hypertension Coronary artery disease Heart failure Dyslipidemia (including high LDL…

…Men Women Points Recommendation Evidence Recommendation Evidence 0 No treatment Low No treatment High 1 Oral anticoagulation (warfarin or NOAK 1 is considered for male…

…depends on plasma volume and plasma renin activity. Volume depletion and high plasma renin activity increase the effect of enalaprilat, and may cause severe hypotension…

…risk A score of 3 or higher indicates high risk of major bleeding Note that a high HAS BLED score should not be used as…

…The HCM Risk SCD score aims to identify individuals with a high risk of SCD and determine whether an implantable cardioverter defibrillator (ICD) is warranted…