…of an upper or lower limb that causes tissue metabolic requirements to exceed available blood flow. The resulting ischaemia threatens skeletal muscle and peripheral nerves…

…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…

…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…

…peripheral artery to the aortic root and coronary ostia. It remains the reference standard for defining the extent of coronary artery disease because it provides…

…particularly in iatrogenic aortic injury. Iatrogenic lesions commonly follow cardiac surgery, coronary angiography or other invasive procedures, and affected patients may be relatively painless compared…

…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…

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

…ICU is the preferred level of care for the absolute majority. The CCU may be suitable for stable (hemodynamically and respiratory) and fully conscious patients…

…The test presupposes that the patient has spontaneous nystagmus at the time of examination and that the examiner is experienced with the head impulse test…

…serum concentration. Alkalinisation increases renal elimination several fold and at the same time reduces the passage of salicylate into the central nervous system. Contact your…

…accounting for approximately 80% of cases. Other causes include acute mechanical complications—particularly ventricular septal defect (VSD) and papillary muscle rupture with acute severe mitral…

…Respiratory rate and oxygenation Evidence of systemic congestion or acute RV failure Syncope or altered clinical status Comorbid cardiopulmonary disease, active cancer, and other conditions…

…rate. Within the context of acute coronary syndromes, particularly ST elevation myocardial infarction (STEMI), ischemic injury can disrupt the conduction system at any level, producing…

…or other vascular beds. Malignant hypertension represents an extreme form in which acute microvascular injury occurs, classically involving fibrinoid necrosis of small arteries in the…

…Other mechanisms include thrombosis, embolism, vasculitis, fibromuscular dysplasia, arterial entrapment, cystic adventitial disease and trauma. Atherosclerotic PAD is a manifestation of systemic arterial disease rather…

…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…

…UA) is an acute coronary syndrome characterized by myocardial ischaemia occurring at rest or with minimal exertion, without evidence of acute cardiomyocyte injury or necrosis…

…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…

…in other reports. It is more frequent in women and in patients presenting with NSTEMI than in those presenting with STEMI. Approximately one third of…

…also contributes to the extension and severity of ischemic injury. In its most severe form, known as no reflow, structural and functional impairments sustain vascular…

…liver injury is the commonest cause Isolated bilirubin Unconjugated, the others normal Gilbert's syndrome, haemolysis The R value = (ALT / upper limit of normal…

…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…

…and endothelial or myocardial injury. Antithrombotic therapy may reduce embolization of thrombotic or atheroembolic material, but pharmacological and mechanical strategies directed specifically at reperfusion injury…

…however, display both ECG changes and symptoms. Troponins and other biomarkers of myocardial necrosis (infarction) Myocardium can endure 20 to 30 minutes of complete ischemia…

…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…

…and imaging technique. Coronary fistulae represent abnormal communications between a coronary artery and a cardiac chamber or vessel. Other congenital anomalies include anomalous origin of…

…aortic syndrome, acute kidney injury, microangiopathic haemolysis, and severe pre eclampsia or eclampsia. The blood pressure is often at least 180/120 mmHg, but no…

…Myocardial injury leads to release of cardiac troponin, but troponin elevation is not specific for myocardial infarction. Other conditions may produce cardiomyocyte injury and elevated…

…segment depression is a common and early electrocardiographic sign of acute pericarditis, reflecting pericardial involvement overlying the atria [4, 5]. Other Differential Diagnoses ST segment…

…transmural ischemia. On the other hand, leads V1–V3 (occasionally V4) may detect the injury currents and present them as ST segment depressions. These depressions…

…macrophages, neurons and other tissues. This distribution helps explain why PA produces cardiovascular injury beyond its effects on blood pressure and potassium balance. The principal…

…Smooth muscle cells (SMCs) migrate from the tunica media into the intima, driven by platelet derived growth factor (PDGF) and other cytokines. Within the intima…

…injury currents are not strong enough to be detected on leads with opposite angle of observation. Other vectors may interfere with the injury currents, and…

…or at least four drinks for women or five for men on one occasion. Pharmacokinetics and pathophysiology Approximately 95% of ingested ethanol undergoes hepatic metabolism…

…inflammation and other systemic influences. The severity of myocardial injury is determined not only by the epicardial obstruction but also by the vulnerability of the…

…why, or the patient at risk of carbon dioxide retention is given 15 litres on a reservoir mask and drifts off into a respiratory acidosis…

…better alternative. Follow up At an eGFR below 60, or in the presence of albuminuria: check the potassium, calcium, phosphate, PTH, haemoglobin and bicarbonate , review…

…resolution does not consistently permit identification of foamy macrophages. The occurrence of neoatherosclerosis helps explain why ISR and other stent related events may arise well…

…closer monitoring — the patient cannot feel pressure injury Peripheral neuropathy of other cause As above Severe pain Titrate the pressure up gradually Rheumatoid arthritis with…

…Concussion, temporal bone injury, dissection, aminoglycoside toxicity, antiepileptic drugs, alcohol or sedatives Trauma and medication directed workup This corresponds to the principles of TiTrATE, in…

…high shear conditions. Disruption of an atherosclerotic plaque or injury associated with PCI exposes thrombogenic material, promoting platelet activation, aggregation, and fibrin formation. Within a…

…transmural ischemia. On the other hand, leads V1–V3 (occasionally V4) may detect the injury currents and present them as ST segment depressions. These depressions…

…and the abscess sits somewhere that makes incision in the emergency department the wrong move — in the hand, in the medial triangle of the face…

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

…function and drug concentration Gentamicin and other aminoglycosides A single dose initially. If treatment is continued, dosing is guided by drug concentration measurement. At a…

…or unsecured airway in a patient with a reduced level of consciousness Gastric lavage Corrosive injury or suspected oesophageal perforation Gastric lavage Petroleum products Gastric…

…documented before and after every attempt at reduction — otherwise it is impossible to determine afterwards whether a nerve injury was caused by the injury or…

…and release from an early cytosolic pool have all been associated with detectable troponin. High sensitivity assays may therefore identify a continuum of myocardial injury…

…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…

…with at least one value above the 99th percentile upper reference limit (URL). The injury is considered acute if there is a documented rise and…

…cardiac arrest is witnessed and the rhythm is shockable). This is explained by the fact that there are no means of determining what phase the…

…nerve injury will heal badly however neatly the suture is placed. The commonest cause of wound infection is retained contamination, not poor suture technique — and…

…eliminating the need for more invasive and costly direct measurements of GFR. Limitations of MDRD eGFR Accuracy at Higher GFR Levels: The MDRD equation tends…

…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…

…eye injury is to measure and document the visual acuity before anything else is done. The second most important is to look for signs of…

…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…

…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…

…the tourniquet 10–15 cm proximal to the intended puncture site, let the arm hang, ask the patient to pump with the hand, and pa

…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…