…myositis with muscle inflammation and elevated CK. Rhabdomyolysis is a rare, severe form of muscle injury. The biological basis of many reported muscle symptoms remains…

…to a prosthesis) — a high risk of avascular necrosis of the femoral head and of vascular injury; always an orthopaedic surgeon, and usually general anaesthesia…

…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…

…musculoskeletal injury risk. Examples include brisk walking, jogging, swimming and cycling. Activities should be selected according to the individual’s preferences, functional status and daily…

…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…

…are components of the myocardial contractile apparatus and are expressed predominantly in cardiac muscle. Troponin I is highly specific for myocardial injury. Interpretation of troponin…

…are cardiac specific isoforms of troponin and these are abbreviated cTnI, cTnT, and cTnC. The isoforms cTnI and cTnT are specific to cardiac muscle cells…

…injury. Influence of Muscle Mass and Diet: Serum creatinine levels, a key component of the MDRD equation, can be affected by factors such as muscle…

…and venous filling may be reduced. Other possible findings include muscle stiffening and loss of deep tendon reflexes. Pulses are absent distal to the obstruction…

…beyond the original infarct zone. Coronary Occlusion and Myocardial Injury STEMI generally results from abrupt reduction in coronary blood flow caused by thrombotic occlusion of…

…muscle cells, leading to a white, platelet rich thrombus. Myocardial vulnerability, largely driven by coronary microvascular dysfunction, also contributes to the extension and severity of…

…eGFR With an atypical muscle mass, or to confirm a creatinine based value The mean of creatinine and cystatin C The most reliable in routine…

…stress and intimal injury promote atherosclerosis. The principal anatomical distributions are: Abdominal aorta and iliac arteries, involved in approximately 30% of symptomatic patients. Femoral and…

…Reliance on hypokalaemia alone therefore misses a substantial proportion of cases. The cardiorenal and cerebrovascular consequences of unrecognized PA make early case detection clinically important…

…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…

…below the lower border of the acromion , in the middle of the muscle belly, within the inverted triangle formed between the acromion and the lower…

…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…

…from transient arrhythmias and minor access site bleeding to myocardial infarction, stroke, coronary perforation, haemodynamic collapse, acute kidney injury, and death. The risk profile differs…

…Chronic: more than 90 days. The central clinical danger is progressive aortic wall disruption, rupture and compromise of branch vessels. Type A disease may cause…

…myocardial territory and limitation of infarct size. The extent of myocardial injury is strongly influenced by total ischaemic time. This interval includes: The time from…

…post procedural morbidity and mortality. Pathophysiology The precise mechanism of contrast induced AKI is incompletely defined. In many cases, the renal injury probably represents acute…

…The mortality rate among patients with elevated troponin I was 51.2%, as compared with 4.5% among patients without evidence of myocardial injury (normal…

…The injury is considered acute if there is a documented rise and/or fall of cTn values. However, myocardial injury alone is an entity in…

…and reperfusion injury. Myocardial oxygen demand Myocardium can only function under aerobic conditions (oxygen is required for ATP synthesis [ATP is the primary energy source…

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

…capillary refill and pulse, and active movement of every tendon crossing the wound. A tendon injury can be painless and gives normal passive movement — test…

…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…

…5th intercostal space along the anterior axillary line. Thoracostomy This method is generally deemed safer than using a needle due to reduced risk of injury…

…measure and document the visual acuity before anything else is done. The second most important is to look for signs of perforation — Seidel's sign…

…about 30 minutes of continuous convulsive activity, t2, the risk of permanent neuronal injury increases. Treatment must therefore start at 5 minutes and be escalated…

…the treatment threshold and on whether haemodialysis should be considered. Rhabdomyolysis with marked elevation of CK and threatened kidney injury, as an adjunct to the…

…roll or the Gufoni manoeuvre for treatment. Contraindications Absolute: Unstable cervical spine injury, recent cervical spine surgery, atlantoaxial instability, severe rheumatoid arthritis of the neck…

…The grading must not be used mechanically. A patient with a plasma potassium of 6.2 mmol/L, new bradycardia and acute kidney injury may…

…in three lengths: short for children and slim limbs, medium for most adults, long for thick soft tissue and for the head of the humerus…

…50 beats per minute in the first 4 to 6 hours after an acute infarction—patients may develop hypotension and signs of end organ hypoperfusion…

…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…

…insufficiency, hepatic injury, thrombocytopenia, coagulopathy, cerebrovascular events, hepatic capsule rupture, placental abruption, disseminated intravascular coagulation, and multiple organ failure. In the absence of treatment, approximately…

…per data from the registry, only suicide attempts have lower survival outcomes. Nonetheless, prompt interventions can reverse cardiac arrest and survivors of traumatic cardiac arrest…

…for example after a stroke. Sampling of gastric contents and evacuation in poisoning (see the separate text on gastric lavage). The tube is not, however…

…for the management of delirium in intensive care. Renal replacement therapy Absolute indications: refractory hyperkalaemia, refractory acidosis, refractory fluid overload, uraemic symptoms (pericarditis, encephalopathy) and…

…and myocardial injury. This classification is central to determining the intensity of monitoring, supportive treatment, anticoagulation, and possible reperfusion. The principal pathophysiological determinant of early…

…or both. The clinical consequences of extracellular volume expansion include elevated cardiac filling pressures, pulmonary congestion, systemic venous hypertension, and peripheral interstitial edema. These abnormalities…

…of approximately 1–8 weeks. The pathogenesis is presumed to be immune mediated. Pericardial injury, necrosis, bleeding, or pleural incision may expose cardiac antigens and…

…for help using the words massive haemorrhage , and state the patient's location and identity, the presumed cause of bleeding, and how the products are…

…gradient between normal and ischaemic myocardium generates currents of injury that are expressed on the surface ECG as ST segment displacement. When the ischaemic vector…

…which the patient has symptoms suggestive of acute coronary syndrome (ACS), biochemical evidence of myocardial injury with corroborating evidence of infarction caused by ischaemia, and…

…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…

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

…Malignant hypertension represents an extreme form in which acute microvascular injury occurs, classically involving fibrinoid necrosis of small arteries in the kidneys, retina, and brain…

…debris obstructs the distal microcirculation and may be accompanied by microvascular constriction and endothelial or myocardial injury. Antithrombotic therapy may reduce embolization of thrombotic or…

…evidence of acute cardiomyocyte injury or necrosis. It is distinguished from acute myocardial infarction (AMI), in which myocardial ischaemia is accompanied by cardiomyocyte necrosis and…

… 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…

…troponin T and troponin I have emerged as the preferred biomarkers because they are extremely sensitive and specific for myocardial injury. Elevated levels of cardiac…

…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…

…a possible donor and the deceased person's own wishes are properly established. Two things determine the outcome — that the confirmation of death is carried…

…Condition Overall strategy Common first choices : : : Acute aortic syndrome Immediate rate control and rapid reduction of the systolic blood pressure towards 100 to 120 mmHg…

…and an undiluted syringe of 10 mg/mL makes small adjustments impossible. Procedure Intravenous titration in acute severe pain Practical points during titration: Give the…

…and before every ear syringing. Removal of cerumen: Hearing loss, a blocked sensation, itching, earache or dizziness attributable to a wax plug. The tympanic membrane…

…carboxyhaemoglobin from oxyhaemoglobin and shows a falsely normal value. Give 100 % oxygen on a reservoir mask — this markedly shortens the half life of carbon monoxide…