…the anterior axillary line. Thoracostomy This method is generally deemed safer than using a needle due to reduced risk of injury. Thoracostomy should be performed…

…there is suspicion of cervical spine injury, in which scenario head tilt chin lift should only be used if other methods fail to open the…

…angina in the past two decades (many of those who would previously have been classified as unstable angina are now classified as NSTEMI due to…

…output can change before creatinine but is not a pure marker of filtration. Oliguria may be due to hypovolaemia, shock, obstruction or advanced renal injury…

…actual structural injury to the tissues. Manifestations of contusio cordis include: Arrhythmias : Ventricular or supraventricular arrhythmias (bradyarrhythmia or tachyarrhythmia). Atrial or ventricular rupture : In severe…

…due to histamine release, not allergy. Concurrent MAO inhibitor, particularly with pethidine. Caution: untreated sleep apnoea, a concurrent benzodiazepine or gabapentinoid, marked hypovolaemia, head injury…

…min). Patients with mild to moderate heart failure, kidney or liver disease, especially when combined with diuretics (risk of fluid retention and impaired kidney function)…

…fall of cTn values. However, myocardial injury alone is an entity in itself and may arise from non ischaemic cardiac conditions (such as myocarditis) or…

…an ischaemic myocardial injury occurring in the context of a mismatch between myocardial oxygen supply and demand, which is not related to acute coronary atherothrombosis…

…may also be referred to as the posterior wall, or the inferobasal wall. Transmural ischemia located in this area yields an injury current (ST vector…

…be obtained or become abnormal, in the presence of symptoms suggestive of ischaemia and presumed new ischaemic ECG changes. The distinction between myocardial injury and…

…contribute to tubular injury, making attribution to contrast alone difficult. In patients with normal renal function, the occurrence of contrast induced AKI is negligible or…

…glaucoma (tonometry). Contraindications Absolute contraindications to instrumental removal: Suspected penetrating injury or an intraocular foreign body — shield the eye with a rigid shield, give systemic…

…myocardial injury , demonstrated by a rise and/or fall in cTn with at least one value above the 99th percentile URL; and Clinical evidence of…

…ligament injury, a tendon injury, or after suturing over a joint. Pain relief and stabilisation for transfer in a suspected fracture. Clinical suspicion of a…

…fine needle and 5 minutes of compression. Anticoagulant treatment is not in itself a bar to vaccination. Relative: Lymphoedema or previous axillary clearance on the…

…tendon injury that was sutured over without being found. Indications A traumatic wound that gapes and cannot be expected to heal with good function or…

…ischaemia (ALI) is an abrupt reduction in arterial perfusion of an upper or lower limb that causes tissue metabolic requirements to exceed available blood flow…

…refers to refractory cardiogenic shock or the need for ongoing cardiopulmonary resuscitation. Mechanical circulatory support, including extracorporeal membrane oxygenation (ECMO), may be required in this…

…and signs of end organ hypoperfusion. In severe cases, bradycardia may progress to bradyarrhythmic arrest or pulseless electrical activity (PEA), presenting as cardiovascular collapse and…

…Acute ischemic or intracerebral haemorrhage may coexist with severe hypertension. The decision to lower BP in acute stroke requires attention to the type of stroke…

…detailed symptom to anatomy correlation. Pain may be absent, particularly in iatrogenic aortic injury. Iatrogenic lesions commonly follow cardiac surgery, coronary angiography or other invasive…

…stenosis in a major epicardial coronary artery. Non obstructive disease is generally defined as the absence of a stenosis of 50% or more in any…

…presumed to be immune mediated. Pericardial injury, necrosis, bleeding, or pleural incision may expose cardiac antigens and initiate an inflammatory response. The presence of antibodies…

…of persistent ST segment elevation or an accepted equivalent in the setting of ischaemic symptoms. The immediate pathophysiological objective is restoration of blood flow to…

…UA belongs to the broader spectrum of acute coronary syndromes, which may present with recent changes in symptoms or signs, with or without ECG abnormalities…

…care The time from withdrawal of treatment to circulatory arrest Indications An intensive care patient with severe brain injury in whom total brain infarction is…

…cervical spine injury, recent cervical spine surgery, atlantoaxial instability, severe rheumatoid arthritis of the neck. Symptomatic carotid stenosis, recent stroke or TIA in the vertebrobasilar…

…Inadequate ventilation with a rising pCO₂ and respiratory acidosis, or a markedly increased work of breathing with impending exhaustion. Threatened airway obstruction: inhalation injury, anaphylaxis…

…5.5 to 5.9 mmol/L Confirm the value, address the cause, assess renal function and the rate of rise. Often outpatient or brief…

…intravenous drugs. Such treatment has not been shown to improve the prognosis and can cause hypotension, acute kidney injury, myocardial ischaemia or cerebral hypoperfusion. Pain…

…Comment : : : MAP ≥ 65 mmHg 80–85 mmHg in chronic hypertension or when there are signs of inadequate perfusion Urine output 0.5 mL/kg/h…

…Go through the medication and any herbal preparations carefully — drug induced liver injury is the commonest cause of acute liver failure in the Nordic countries.

…fracture or a marked midfacial fracture — the tube can pass through a fracture in the cribriform plate into the cranium Absolute Corrosive injury of the…

…of infection A small or uncooperative child Movement causes injury Preparation and equipment Otoscopy: an otoscope with a charged battery and clean disposable specula in…

…A fracture of the bone to be punctured, or a major injury proximal to the puncture site. A joint prosthesis or orthopaedic metalwork in the…

…impossible to determine afterwards whether a nerve injury was caused by the injury or by the treatment. Indications A clinically or radiologically confirmed dislocation of…

…or to confirm a creatinine based value The mean of creatinine and cystatin C The most reliable in routine clinical practice Cockcroft–Gault Still used…

…ABCDE assessment and document the time of seizure onset, or the time the patient was last known to be well. Protect the patient from injury…

…or in parallel; otherwise the treatment is ineffective. Hypocalcaemia , symptomatic. Alkalosis increases the binding of calcium to albumin and lowers ionised calcium further; risk of…

…studies of the urinary tract. Wound healing with a sacral pressure sore or extensive perineal wounds where urinary leakage prevents healing. Voiding problems in neurogenic…

…to underestimate GFR in individuals with near normal or mildly reduced kidney function (eGFR 60 mL/min/1.73 m²), potentially leading to misclassification of…

…with myocardial injury. Relationship to chronic coronary syndromes Chronic coronary syndromes (CCS) describe stable period clinical presentations arising from structural or functional abnormalities of the…

…Subclinical cerebral injury may contribute to vascular dementia, and thromboembolism may affect organs other than the brain. Patients with AF in the setting of ACS…

…The central pathophysiological concern in the emergency department is myocardial ischaemia caused by an acute coronary process. Myocardial injury leads to release of cardiac troponin…

…axillary or subclavian arteries may increase the risk of embolization. Risk assessment should be individualized. There are no absolute contraindications to coronary angiography in the…

…a detailed list of physical examination findings or a specific examination sequence. It does, however, emphasize that symptoms and vital signs contribute to initial triage…

…Stent fracture or collapse Residual edge dissection Incomplete lesion preparation Persistent stenosis within the treated segment Mechanical factors are particularly important because correction of the…

…is attached to infarcted myocardium, superficial components may detach and embolize systemically. Observational data indicate approximately a fourfold greater risk of embolic events in patients…

…cardiovascular and renal injury. Adipokine imbalance contributes to insulin resistance, β cell failure, endothelial dysfunction and atherosclerosis. Ectopic fat deposited around or within the heart…

…related to the extent of myocardium at risk. Occlusion or impaired perfusion in a vessel supplying a large viable territory is more likely to produce…

…the presence of multilevel disease and collateral circulation. Flow limitation may be clinically silent, manifest as exertional symptoms, or progress to chronic limb threatening ischaemia…

…magnetic resonance imaging has demonstrated procedural injury in patients undergoing either procedure, and postprocedural cTnI elevation correlates with evidence of injury on cardiac magnetic resonance…

…may also be referred to as the posterior wall, or the inferobasal wall. Transmural ischemia located in this area yields an injury current (ST vector…

…as part of an inferoposterior or posterolateral infarction. Its recognition is clinically important because posterior infarction may not produce conventional ST segment elevation in the…

…1 in 100 cases of preeclampsia may progress to eclampsia. Clinical presentation and symptoms The clinical spectrum ranges from hypertension without apparent organ injury to…

…develop weakness, muscle cramps or, in severe cases, periodic paralysis. Nevertheless, many patients are normokalaemic and have no distinctive symptoms attributable to aldosterone excess. Cardiovascular…

…abrupt reduction in coronary blood flow caused by thrombotic occlusion of a previously atherosclerotic artery. Plaque erosion or rupture exposes thrombogenic material to circulating blood…

…myocardial injury. Clinical Presentation and Symptoms In up to one half of STEMI cases, a precipitating factor such as vigorous physical exercise, emotional stress, or…

…factor is identifiable in up to one half of cases. Reported precipitants include vigorous physical activity, emotional stress, and an intercurrent medical or surgical illness…