…vascular surgical assessment Exercise ABI. With a normal or borderline resting ABI but typical claudication, the ankle pressure is measured immediately after treadmill walking or…

…CCU), or catheterization laboratory. A 12 lead ECG must be obtained immediately after ROSC in order to identify cases with ST segment elevations, which demand…

…Cardiogenic shock. Complete transection of a papillary muscle may cause immediately overwhelming MR. Partial rupture, often involving the tip or head of the muscle, more…

…T waves are called post ischemic T waves and they indicate that the infarction process is more or less completed. Post ischemic T wave inversions…

…injection has gone to the right place — immediate pain relief is a diagnostic finding — and appears to reduce the risk of a post injection flare…

…of cerebral anoxia or brain death and constitute an adverse prognostic sign. Notably, the presence of dilated, nonreactive pupils 48 hours post cardiac arrest is…

…given. Each infusion should be completed, even if the patient reverts to sinus rhythm. Th e infusion must be aborted if hypotension or bradycardia occurs…

…percutaneous coronary intervention (PCI), or medical management. The standard post ACS regimen is DAPT for 12 months, generally consisting of low dose aspirin and a…

…In patients with acute coronary syndromes (ACS), the early post event period is particularly vulnerable, and delayed intensification of lipid lowering therapy may leave patients…

…propofol, or etomidate), routine blood pressure and oximetry monitoring, availability of atropine, isoproterenol, or transcutaneous pacing for post shock bradycardia, and use of biphasic defibrillators…

Echocardiography Echocardiographic assessment of left ventricular diastolic function Methods for evaluating left ventricular diastolic function have evolved considerably in the past two decades. Currently recommended…

…In septic shock, or where sepsis is highly likely, antibiotics must be given immediately [3]. This quick reference applies chiefly to adults with neutropenia related…

…a sensation, which threatens instant death if the motion is persisted in; and, that on stopping, the distress immediately abates, or altogether subsides; have . . . formed…

…attempt in the same bone within the past 24 hours — the fluid leaks out through the old hole. Infection or burns over the puncture site…

…ischaemia Paraplegia or paraparesis Persistent or recurrent pain Hypertension that remains uncontrolled despite optimal therapy Acute type A dissection has a particularly rapid early mortality…

…4. Start an inhaled short acting β2 agonist immediately. 5. Add ipratropium in a severe or life threatening attack. 6. Give a systemic steroid early…

Akutsjukvård Kirurgi & trauma Lathundar Immediate management In massive haemorrhage it is rapid control of the bleeding that determines the outcome. Transfusion restores circulating volume, oxygen…

…Do not routinely stop aspirin given as secondary prevention 8 Contact the endoscopist and the consultant on call early. In cirrhosis or suspected variceal bleeding…

…long has the fibrillation lasted, and does the patient need an anticoagulant? The unstable patient Immediate electrical cardioversion, without delay, in any of the following…

…treatment. 5. With severe symptoms: give hypertonic saline immediately. Do not wait for a complete work up of the cause or for imaging. 6. Document…

…on persistent ST segment elevation or an equivalent electrocardiographic pattern in a patient with symptoms of myocardial ischaemia. The immediate therapeutic objective is restoration of…

…Mechanical or pump failure complications , including heart failure and cardiogenic shock. Most out of hospital deaths occur early and are commonly related to ventricular fibrillation…

…and rapid progression to cardiogenic shock. Ventricular fibrillation or asystole may occur early due to the massive ischemia. Complete LMCA occlusion is typically fatal within…

…and aortic dissection or active major bleeding is not suspected. 6. Call the PCI service immediately in STEMI, a STEMI equivalent or very high risk…

…Measure immediately and correct marked hypoglycaemia Time of onset Document the exact clock time of symptom onset or the time last known to be well…

…risk [3]. Questions that rapidly change management Ask specifically about: Neurological symptoms: confusion, visual loss, focal neurological signs, seizures, severe or sudden headache. Chest pain…

…Measure the plasma glucose immediately in everyone with a reduced level of consciousness, seizures, confusion, a change in behaviour, collapse or an acute neurological deficit…

…Indications Immediate (transcutaneous) pacing in bradycardia with haemodynamic compromise — hypotension, shock, impaired consciousness, heart failure, myocardial ischaemia or syncope — that has not responded to atropine…

…therapy, or markedly prolonged QT intervals—the implantation of an implantable cardioverter defibrillator (ICD) is recommended. ICDs provide immediate intervention during life threatening arrhythmias, thereby…

…therapy, or markedly prolonged QT intervals—the implantation of an implantable cardioverter defibrillator (ICD) is recommended. ICDs provide immediate intervention during life threatening arrhythmias, thereby…

…or low intensity lipid lowering therapy: • Start high potency, high dose statin therapy (Class I recommendation). • Immediate combination with ezetimibe can be considered if LDL…

…and anxiety related disorders. The immediate objective is not simply to establish whether the patient has ACS. It is to determine whether the patient is…

…provides anatomical information while permitting functional assessment and, when appropriate, immediate percutaneous coronary intervention (PCI). Complications are uncommon, but their clinical spectrum ranges from transient…

…vigorous physical exercise, emotional stress, or a medical or surgical illness is present before the event. Although STEMI may occur at any time, circadian variations…

…pulseless electrical activity (PEA) as the initial rhythm, while the remainder manifest ventricular fibrillation (VF) or asystole ( Ebo et al ). Clinical manifestations of anaphylaxis Nervousness…

…or when the fundal height surpasses the umbilicus, the uterus should be manually displaced to the woman's left side (Figure 1). Additional offloading of…

CPR Extracorporeal Life Support (ECLS) and ECMO (Extracorporeal Membrane Oxygenation) Survival after cardiac arrest depends on the restoration of spontaneous cardiac rhythm. The likelihood of…

…artery or its branches. The larger the thrombus, the more proximal the occlusion and, hence, the greater the hemodynamic effects. The occlusion has two immediate…

…is simple: transmural ischemia is due to a complete and proximal artery occlusion and such occlusions must be managed with immediate PCI (Percutaneous Coronary Angiography)…

…e. septal bulging ). Bedside echocardiography allows for immediate recognition of tamponade. Typically, acute tamponade arises from aortic dissection, and survival among such patients is, unfortunately…

…Cardiopulmonary Resuscitation (CPR). Cardiac arrest ensues when ventricular contractions cease or are meaningless. This immediately leads to syncope and soon death, unless resuscitation is attempted…

…Regardless of etiology and ECG, ventricular tachycardia is always a potentially life threatening arrhythmia that requires immediate attention. The ventricular rate is typically very high…

…Seizures later than this, focal seizures or status epilepticus should raise strong suspicion of another or an additional cause [1]. Delirium tremens most often begins…

…adrenaline immediately Severe anaphylaxis Hypoxia, marked bronchospasm, stridor, hypotension, collapse or impaired consciousness Adrenaline, oxygen, intravenous access, fluid and early contact with anaesthesia or intensive…

…least two occasions, and preferably confirmation by home measurement or 24 hour recording — the thresholds for which are lower than for office measurement. Classification of…

…or hyperkalaemic ECG changes at any level Immediate emergency treatment, continuous ECG monitoring and early assessment of the need for dialysis ECG changes or serious…

…important precautions. A hypertensive emergency is defined by a markedly raised blood pressure in combination with new or progressive acute target organ damage. Common manifestations…

…VF, necessitating immediate defibrillation. In the context of cancer therapy, patients may develop new cardiac symptoms such as syncope, pre syncope, or rapid palpitations. These…

…pain or functional loss reduce the likelihood of successful limb salvage. Evaluation and physical examination ALI requires immediate clinical assessment by a vascular specialist or…

…anticoagulation, and possible reperfusion. The principal pathophysiological determinant of early adverse outcome is acute RV failure. In acute PE, obstruction of pulmonary blood flow increases…

…typical symptoms or symptom burden of uncomplicated hypertension. It does, however, identify symptomatic hypotension and symptoms suggestive of orthostatic hypotension as indications for additional postural…

…newly detected for the first time, or newly developed during management of an acute illness. The clinical relationship between AF and acute deterioration is often…

…its serial change A simplified interpretation is shown below. Clinical and diagnostic pattern Likely triage or diagnosis Low likelihood symptoms, normal ECG, low or unchanged…

…that extends into the media or adventitia can compromise the true lumen and cause ischemia. Guiding catheter trauma is an additional mechanism of dissection and…

…from out of hospital cardiac arrest should not routinely undergo immediate angiography. A selective or delayed approach is recommended in this setting unless other findings…

…stability. Define the operative electrical environment The surgical team should establish: Whether electrosurgery or diathermy will be used. Whether monopolar or bipolar electrocautery is planned…

Cardiology Clinical medicine Definition and clinical classification Hypertensive disorders of pregnancy comprise chronic or pre existing hypertension, gestational hypertension, and preeclampsia. Collectively, they affect approximately…

…in V6 with QRS duration <120 ms) D: Profound sinus bradycardia (<30 beats/min or sinus pauses ≥3 s) Explanation: Incomplete Right Bundle Branch Block…

…A rapid increase in preload (e.g by increasing venous return to the heart in supine position) leads to an immediate increase in ejection fraction…

…or an identity check performed at the nurses' station instead of at the bedside. The check against the patient's own identity immediately before transfusion…