…but not high sensitivity, assays detect troponin in approximately 20–50%. Their greater analytical sensitivity improves diagnostic accuracy and negative predictive value in patients with…

…Shortening therapy to one to three months is an option when bleeding risk is very high. Prasugrel or ticagrelor may be considered after complex interventions…

…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…

…<4 hours. Delivery IV or IM. Dose Injections • IV: 10–40 mg every 4–6 hours • IM: 10–20 mg every 4–6 hours. Infusion…

…with apoB. Discordantly high apoB is especially associated with metabolic syndrome and mildly elevated triglycerides, even when LDL C is normal or low. Clinical Significance…

…or its connected myocardium may also result in mitral prolapse. Extensive myocardial infarction may lead to papillary muscle rupture. The risk of rupture is greater…

…develop despite a measurable or high blood alcohol concentration, particularly in patients with marked tolerance. The most important measures in severe or complicated withdrawal are…

…Normal 120–129 and/or 80–84 High normal 130–139 and/or 85–89 Grade 1 hypertension 140–159 and/or 90–99 Grade…

…false positives; at a high probability a negative test adds little. Imaging (coronary CT angiography, myocardial perfusion scintigraphy, stress echocardiography) has greater diagnostic accuracy. Contraindications…

…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…

…infusion or injections Drugs for type 2 diabetes in inpatients Agent The acutely ill inpatient : : Metformin Stop in acute kidney injury, hypoxia, shock, before contrast…

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

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

…with Ticagrelor 90 mg or treatment with another adenosine diphosphate (ADP) receptor inhibitor for patients who had coronary syndrome and are at high risk of…

All patients with NSTE ACS (NSTEMI or unstable angina) are treated similarly with respect to anti ischemic and anti thrombotic drugs. Management must, however, be…

…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…

…life. The underlying aetiology is heterogeneous. Chronic heart failure evaluation should therefore seek reversible or treatable causes. The source material identifies coronary disease, hypertension, diabetes…

…social plattforms: Is high cholesterol a true cause of coronary artery disease? Does diet affect cholesterol levels? Are statins really effective, or is it all…

…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…

…at a particular symptom complex. The source material does not describe a characteristic symptom profile at initiation or during routine therapy. Potential clinically important complications…

…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)…

…system (CNS) injuries might cause apnea or hypoventilation. Respiratory conditions : Tension pneumothorax Drowning Airway obstruction Hanging Pneumonia High altitude sickness Aspiration Chronic obstructive pulmonary disease…

…hypotension or has a lactate level exceeding 4 mmol/l, commence an intravenous fluid resuscitation using a crystalloid solution at a dose of 30 ml…

…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…

…young individuals. The severity of symptoms and presence of high risk arrhythmias on ECG guides the management of non acute or asymptomatic bradyarrhythmia. In patients…

…should expand substantially. This requires that the myocardium has high compliance , a term used to describe myocardial elasticity. The greater the compliance, the more rapid…

…pads if the patient is unstable or at marked risk of arrhythmia. 4. Take a full blood count, electrolytes, creatinine, glucose, high sensitivity troponin and…

…damage. Suspected masked hypertension: normal office blood pressure but organ damage or high risk. Treatment resistant hypertension. Suspected nocturnal hypertension or absent nocturnal dipping (diabetes…

…15 49 mL/min Edoxaban 60 mg once daily 30 mg once daily at eGFR 15 50 mL/min, weight ≤60 kg or concomitant P…

…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…

…IPAP against hypercapnia SpO₂ 88–92% Hypoxaemic failure without hypercapnia CPAP or high flow nasal oxygen 5–10 cmH₂O According to oxygenation requirement SpO₂ 92…

…several non pharmacological measures at the same time, and use drugs only in severe agitation or marked distress. Delirium is an acute neuropsychiatric syndrome and…

…very high glucose value is no longer required [1]. Diabetic ketoacidosis, DKA Hyperosmolar hyperglycaemic state, HHS : : : Glucose Plasma glucose ≥ 11.1 mmol/L or previously…

…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…

…to edrophonium. Mechanical obstruction of the bowel or the urinary tract. Marked bradycardia, sick sinus syndrome or high grade AV block without pacemaker protection. Asthma…

…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…

…arrhythmias. Myocardial ischaemia. Tissue ischaemia (high doses or extravasation). Dopamine — high dose Cardiogenic shock. Vasodilatory shock. Heart failure, acute or chronic. Bradycardia (second line option)…

…A need for high airway pressures, for example severe ARDS, marked obesity or a stiff chest wall. Glottic or subglottic obstruction — the mask sits above…

…hyperkeratotic Pulses Palpable Weak or absent May be palpable despite ischaemia ABI 0.9 < 0.9 Often falsely high Contraindications to compression The ankle…

…suspected when the FVC is low with a normal or high ratio. Reversibility: an increase in FEV₁ or FVC of 10 % of the predicted value…

…septic shock, or a need for high dependency or intensive care 3 Take at least two sets of blood cultures from separate peripheral punctures. Also…

…Contact your national or regional poison control centre regarding hyperbaric treatment. Cluster headache. High flow oxygen on a reservoir mask is the first line treatment…

…Haemodynamics Right ventricular strain (echo or CT) Troponin Management : : : : : High Unstable Yes Often raised Reperfusion, intensive care Intermediate–high Stable Yes Raised Admission with monitoring…

…neurovascular compromise or skin tenting — reduce promptly, before radiography. The longer a joint remains dislocated, the harder the reduction becomes and the greater the risk…

…for hypotension or hypoperfusion, usually 500 mL as a rapid bolus, and a smaller bolus where the risk of fluid overload is high 0 to…

…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…

…quality tap water or sodium chloride 9 mg/mL. The volume matters more than the fluid; irrigate under pressure through a 20 mL syringe 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…

…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…

…of bleeding Low risk 0 3 0.8% Intermediate risk 4 2.6% High risk 5 or more 5.8% Interpretation of ATRIA risk score…

…muscle, and bone mass. It does not indicate the types or distribution of body fat. It may not be accurate for all populations, particularly at…

…The aim of CHADS VASc is to identify patients at high risk of stroke, TIA or systemic thromboembolism and initiate treatment with anticoagulants (rarely with…

…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…

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

…intermediate, or high risk categories. A significant shortcoming of the HCM Risk SCD Score is the absence of magnetic resonance imaging parameters (extent of myocardial…