…Usually hospital based, often ICU Usually outpatient Initial treatment Carefully titrated intravenous therapy when indicated Oral treatment and prompt follow up Main risk of management…

…suitable for stable (hemodynamically and respiratory) and fully conscious patients who experienced a brief cardiac arrest. Post resuscitation care is an integral component of the…

…assume normal renal and hepatic function, a non pregnant adult of normal weight, and individual assessment. See the separate quick reference for dosing in impaired…

…and gastric lavage is today a rare procedure reserved for very serious poisonings in which the patient reaches hospital early. The benefit of both methods…

…for the rescuer, victim and bystanders. Relocate to a safe position if required. 2. Confirm cardiac arrest In case of a collapse (out of hospital…

…Upon recognition of a cardiac arrest in a pregnant individual, either within or outside the hospital, prompt communication with an obstetrician and neonatologist is critical…

…team (CAT) and intensive care units and other units caring for resuscitated patients. Figure 1. The chain of survival in out of hospital cardiac arrest…

…an indication for dialysis? AKI occurs in about one fifth of adults during a hospital episode in international studies and is linked to substantial mortality…

…wait for laboratory results, CT or EEG before the first dose of benzodiazepine is given. Airway, breathing and circulation Perform an ABCDE assessment and document…

…exhibited a higher risk of major and minor bleeding, as classified by the TIMI system (Thrombolysis in Myocardial Infarction). Prasugrel should only be considered for…

…hospital mortality was 42.4% for STEMI associated mechanical complications and 18% for those associated with NSTEMI. The timing of VSR, free wall rupture, and…

…recurrence of a wide variety of supraventricular tachycardias (SVTs), including atrial flutter, atrial tachycardia, AV node reentry, and AV reentry. In the management of AF…

…transcatheter intervention, with temporary mechanical circulatory support (MCS) considered as a bridge. Clinical Presentation and Symptoms Symptoms of STEMI The usual symptom is severe, prolonged…

…although older patients also have more contraindications and a greater risk of bleeding and myocardial rupture. Late presentation For patients presenting more than 12 hours…

…Assessment for high risk mechanical complications. Determination of symptom onset time and anticipated time to primary PCI. Patients with STEMI should be monitored in a…

…the University of Gothenburg and Sahlgrenska University Hospital, Sweden, is the force behind the comprehensive online course at ecgwaves.com. This website provides a comprehensive…

…possible. Airway management should not interrupt compressions for more than 5 seconds. The effect of cricoid pressure and gastric insufflation remains uncertain ( Panchal et al )…

…circumstances. The initial rhythm is an indicator of the underlying etiology, duration of cardiac arrest, quality of CPR, and a prognostic indicator for survival. In…

…is a fundamental neurological examination finding that reflects brainstem (midbrain) function. In the context of cardiac arrest and the post resuscitation period, assessment of the…

…hypersensitivity and anaphylaxis: a narrative review. Br J Anaesth 2019; 123:e3849. Wallmuller C, Meron G, Kurkciyan I, et al. Causes of in hospital cardiac…

…hospital arrival has been recorded at 27%, while for witnessed cardiac arrests, the survival rate stands at 73% (Podsiadlo et al.). A significant majority of…

…arrhythmias and cardiac arrest. It is clear that only a negligible fraction of all episodes of myocardial ischemia result in cardiac arrest. In order for…

…and noncoronary cusp (NCC), showing the same branches as in panel A for cross modality comparison. Clinical features Occlusion of the left main coronary artery…

…1000 hospital admissions ( Nolan et al ). Survival in cardiac arrest Survival in OHCA Yan et al performed a meta analysis and systematic review of 141…

…accounting for 50% of all cardiovascular deaths ( Tsao et al ). A recent meta analysis showed that survival to hospital discharge is 8.8% and survival…

…as allowing for gas exchange in the lungs. A large number of experimental and observational studies have been conducted to optimize the effectiveness of CPR…

…thrombolysis and PCI wire crossing. Exact times are needed for continued management and quality follow up. STEMI: time targets and choice of reperfusion Primary PCI…

…92 percent No risk of hypercapnia and a normal blood gas Usually 94 to 98 percent An individually documented target prescription, for example in chronic…

…care in the hospital. Endocrine Society clinical practice guideline on the management of hyperglycaemia in hospitalised adults. The summary of product characteristics for each insulin…

…a central venous catheter, ECG monitoring, blood gases. Drugs for sedation, analgesia and control of shivering. Procedure 1. Start temperature management early — within the first…

…there is a high probability of ongoing myocardial ischemia. IIa C Pre hospital logistics Management Recommendation Level of evidence The pre hospital care of STEMI…

…Sahlgrenska University Hospital, Sweden References Jervell A, Lange Nielsen F. Congenital deaf mutism, functional heart disease with prolongation of the Q T interval and sudden…

…Pharmacology & dosing Definition and Pathophysiology Angiotensin converting enzyme inhibitors (ACE inhibitors) constitute a cornerstone in the management of cardiovascular disease, heart failure, and chronic kidney…

…to the emergence of symptoms. Evaluation Before Rehabilitation Clinical assessment Rehabilitation begins with patient assessment and ongoing medical surveillance. The programme should account for: The…

…factors for poor outcomes. The vast majority of infections with COVID 19 result in mild disease, with symptoms similar to seasonal flu (influenza) and other…

…causes of shock. Patients with moderate to severe chronic kidney disease have a higher burden of comorbidity and an increased risk of in hospital complications…

…in a widened QRS complex and secondary ST T wave abnormalities [7]. Diagnostic Criteria The diagnostic requirements for LBBB vary by the stringency of the…

…establish a benign diagnosis. ANOCA/INOCA is associated with recurrent symptoms, impaired quality of life, repeated hospital presentations and angiography, and increased short and long…

Cardiology Critical care Pharmacology & dosing Definition and Pathophysiology In the management of acute heart failure and cardiogenic shock, intravenous vasoactive agents are categorised according to…

…patient stable without high risk characteristics and therefore potentially suitable for a selective invasive approach? Is the clinical likelihood of true NSTE ACS low enough…

…can shorten the time to diagnosis and facilitate triage of patients with suspected ST segment elevation myocardial infarction to a percutaneous coronary intervention capable hospital…

…and bundle branch block. Cardiac monitoring is indicated for patients with a high pretest probability of arrhythmia causing syncope. In hospital monitoring is reserved for…

…of management of patients with chest pain. A 12 lead ECG recording must be registered and interpreted within 10 minutes of arrival at the hospital…

…usually a progressive disease. Complications of atrial fibrillation and available treatments In multivariable models (i.e statistical models in which adjustment has been made for…

…et al. Epidemiology and outcome of adult out of hospital cardiac arrest of non cardiac origin in Osaka: a population based study. BMJ Open 2014…

…upon hospital arrival: a retrospective multicenter study. Crit Care 2020; 24:541. Ebo DG, Clarke RC, Mertes PM, et al. Molecular mechanisms and pathophysiology of…

…upon hospital arrival: a retrospective multicenter study. Crit Care 2020;24:541. Ebo DG, Clarke RC, Mertes PM, et al. Molecular mechanisms and pathophysiology of…

…upon hospital arrival: a retrospective multicenter study. Crit Care 2020; 24:541. Ebo DG, Clarke RC, Mertes PM, et al. Molecular mechanisms and pathophysiology of…

…out of hospital cardiac arrest. Patients aged 18 to 70, who received bystander CPR and initially presented with a ventricular arrhythmia without return of spontaneous…

…Sudden cardiac arrest and death Cardiac arrest is the mechanism of death for most diseases and conditions, including non cardiovascular conditions. A cardiac arrest can…

…the end of infusion. Refer to Table 2 for a comparison between levosimendan, milrinone and dobutamine. Mechanisms of action Levosimendan exhibits both inotropic and vasodilatory…

…The chain of care in acute STEMI Optimal care for patients with STEMI requires a well coordinated system involving both prehospital and hospital based services…

…ECG is 6% and 7%, respectively. A proportion of these patients have a new bundle branch block, which in the case of left bundle branch…

…are no means of determining what phase the patient is in. The three phases following a sudden cardiac arrest were described by Weisfeldt and Becker …

…management, and clinical characteristics. Ventricular tachycardia is a highly nuanced arrhythmia that originates in the ventricles. A wide range of conditions may cause ventricular tachycardia…