…body from the conjunctiva or the cornea. Never use a cotton bud on an embedded corneal foreign body — it scrapes away a large area of…

…membrane potential and action potential duration of affected myocardial cells. The resulting voltage gradient between normal and ischaemic myocardium generates currents of injury that are…

…Definition and staging according to KDIGO Acute kidney injury is present when at least one of the following criteria is met [1]: A rise in…

…is a rise and/or fall in cTn values. An elevated cTn alone does not establish MI, because myocardial injury may occur without myocardial ischaemia…

…longer a joint remains dislocated, the harder the reduction becomes and the greater the risk of chondral and neurovascular injury. Aim for reduction within a…

… female sex; low body mass index; larger arterial sheaths; greater intensity of procedural anticoagulation; complex coronary anatomy and technically difficult PCI. For peri procedural stroke…

…refractory pain and hypertension despite treatment. A related entity is non A non B dissection , which involves the arch without involvement of the ascending aorta…

…myocardial injury and type 2 infarction is particularly important. Type 2 infarction requires clinical evidence of ischaemia; an elevated and dynamically changing troponin concentration without…

…The extent of myocardial injury is strongly influenced by total ischaemic time. This interval includes: The time from symptom onset to recognition and seeking medical…

…many cases, the renal injury probably represents acute tubular necrosis arising from the combined effects of contrast exposure and other ischaemic or nephrotoxic stresses. The…

…4.5% among patients without evidence of myocardial injury (normal troponin I levels). Hence, troponin I was a strong predictor of survival in patients hospitalized…

…injury must be coupled with clinical evidence of acute myocardial ischaemia. The Fourth Universal Definition classifies MI into five distinct subtypes based on pathophysiology and…

…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 …

…the victim's outcome: Neurological injury Myocardial dysfunction Systemic response to reperfusion and ischemia Effects of the underlying cause of cardiac arrest Neurological injuries may…

…contamination, not poor suture technique — and the commonest cause of permanent loss of function is a tendon injury that was sutured over without being found…

…consisting of individuals with CKD, limiting its accuracy when applied to healthy populations or those with acute kidney injury. Influence of Muscle Mass and Diet…

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

…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…

…minutes of continuous convulsive activity, t2, the risk of permanent neuronal injury increases. Treatment must therefore start at 5 minutes and be escalated without unnecessary…

…single reason: without normal potassium the urine cannot be alkalinised. The kidney then chooses to excrete hydrogen ions instead of potassium, and the urine stays…

…in three minutes, without drugs . The diagnosis rests on the history, a positive Dix–Hallpike test and the absence of other neurological findings. The treatment…

…A patient with a plasma potassium of 6.2 mmol/L, new bradycardia and acute kidney injury may be at greater immediate risk than a…

…cannula in a large vein gives many times the flow of a fine needle, and collapsed veins mean that the fine needle is in addition…

…and hyperkalemia. For recurrent symptomatic bradycardia, temporary or permanent pacing may be required. However, transcutaneous pacing in the setting of cardiac arrest has not demonstrated…

…injury. The syndrome is therefore both a clinical risk factor cluster and a marker of broader metabolic dysfunction. Associated abnormalities may include increased apoB and…

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

…ischaemic myocardial injury may coexist, and certain disease entities can span both categories; for example, acute heart failure may occur in the context of acute…

…Nonetheless, prompt interventions can reverse cardiac arrest and survivors of traumatic cardiac arrest often exhibit favorable neurological outcomes ( Rawshani et al ). Traumatic cardiac arrests typically…

…5. Ask the patient to flex the head forward and swallow repeatedly , preferably with sips of water if swallowing is safe. Advance the tube in…

…of tissue injury depends on the site, duration and completeness of occlusion and on the adequacy of collateral blood flow. Ischaemia initially produces pain and…

…zone. Coronary Occlusion and Myocardial Injury STEMI generally results from abrupt reduction in coronary blood flow caused by thrombotic occlusion of a previously atherosclerotic artery…

…evidence of peripheral embolism, or an unexplained drop in arterial pressure. Silent or unrecognized infarction occurs more often in patients without antecedent angina and in…

…about 7.20. Different targets apply when the intracranial pressure is raised: normocapnia (PaCO₂ 4.5–5.0 kPa) and avoidance of hypoxia, since hypercapnia…

…medicine Definition and pathophysiology Acute pulmonary embolism (PE) is classified according to haemodynamic status, clinical severity, evidence of right ventricular (RV) dysfunction, and myocardial injury…

…hemodynamic consequences of congestion by producing a negative sodium and water balance. They can reduce jugular venous pressure, pulmonary congestion, peripheral edema and body weight…

…In patients with pericarditis complicated by constriction, symptoms and signs of right sided heart failure may predominate. Pericardial effusions associated with post infarction pericarditis are…

…No conversion formula (between troponin I and T) has been validated. The risk of interference with antibodies in the blood is higher for troponin I…

…The combination of physiology, rate of bleeding, the pattern of injury or disease, the response to initial treatment and the expected continued bleeding matters more…

…has symptoms suggestive of acute coronary syndrome (ACS), biochemical evidence of myocardial injury with corroborating evidence of infarction caused by ischaemia, and no obstructive stenosis…

…< 2 cholestatic injury, and 2–5 a mixed pattern. Orders of magnitude that direct the work up ALT 50 × the upper limit of normal:…

…Types 2–5 MI have other mechanisms of myocardial ischaemia and necrosis. Unstable angina (UA) represents myocardial ischaemia without demonstrable acute cardiomyocyte injury or necrosis…

…disseminated intravascular coagulation, and abrupt deterioration in renal function. By contrast, hypertensive urgency describes severe hypertension without clinical evidence of acute, ongoing target organ damage…

…without an angiographically evident flow limiting obstruction. Assessment should include: Confirmation that the treated epicardial segment is adequately expanded and not severely obstructed. Exclusion of…

…and symptoms Asymptomatic and atypical disease Fewer than half of patients with PAD have typical symptoms. Many have impaired walking or a slow gait without…

…myocardial ischaemia occurring at rest or with minimal exertion, without evidence of acute cardiomyocyte injury or necrosis. It is distinguished from acute myocardial infarction (AMI…

…to endothelial injury [2] . The process initiates with endothelial dysfunction, a state provoked by systemic risk factors such as hypertension, hyperglycemia, smoking, and turbulent hemodynamic…

… and Evidence that the injury is caused by myocardial ischaemia. Accordingly, acute troponin elevation without evidence of ischaemia represents acute myocardial injury rather than MI…

…of infarction. Early thrombus formation is associated with poor short term prognosis, although early mortality is usually related to the extent of myocardial injury and…

…6 weeks of starting treatment. They generally occur without a marked CK elevation. After statin withdrawal, symptoms usually improve over several weeks and may recur…

…biomarkers because they are extremely sensitive and specific for myocardial injury. Elevated levels of cardiac troponins is firm evidence of myocardial necrosis (i.e infarction…

…right down to the skin — a cast split only through the plaster layer does not relieve the pressure. Common splints and casts Injury Immobilisation Comment…

…The diagnosis and the donor care The time from withdrawal of treatment to circulatory arrest Indications An intensive care patient with severe brain injury in…

…creatinine, acid–base status and signs of myocardial ischaemia must be monitored during treatment [4,6]. Important exceptions Condition Overall strategy Common first choices : : : Acute…

…injection is placed too high — which causes the shoulder injury known as SIRVA. Both are avoided with the right landmark and the right needle length…

…depression, or untreated severe respiratory failure without the possibility of monitoring. Paralytic ileus and suspected obstructive ileus (an opioid can be given for the pain…

…discharge, dizziness, tinnitus, fever in a child without an obvious focus, and before every ear syringing. Removal of cerumen: Hearing loss, a blocked sensation, itching…

…for days without anyone asking why, or the patient at risk of carbon dioxide retention is given 15 litres on a reservoir mask and drifts…

…not the value normalised to body surface area — the difference is substantial in very small and very large people. Acute kidney injury (KDIGO) Stage Creatinine…

…the efficacy of diuretics and antihypertensives. Risk of acute kidney injury increases when combined with ACE inhibitors. Corticosteroids and other NSAIDs: Increased risk of gastrointestinal…

…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…