…vulnerable to toxic injury because of its high blood flow and the concentration of filtered substances along the nephron as water is reabsorbed. Nephrotoxic injury…

…therefore identify a continuum of myocardial injury ranging from minor or reversible injury to extensive necrosis. Causes of myocardial injury Important causes include: Mechanism or…

…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…

…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…

…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…

…valves, due to a direct, non penetrating traumatic blow to the chest. Unlike commotio cordis, contusio cordis implies actual structural injury to the tissues. Manifestations…

…The 3 phase model of sudden cardiac arrest. According to Weisfeldt et al (2002) . The existence of these stages is supported by a wide range…

Procedurer Emptying the stomach has gone from routine to exception. Activated charcoal — in Sweden usually called medicinal charcoal — is the first line measure in decontamination…

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

…is classified according to haemodynamic status, clinical severity, evidence of right ventricular (RV) dysfunction, and myocardial injury. This classification is central to determining the intensity…

…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…

…in traumatic brain injury Cerebral perfusion pressure (CPP) 60–70 mmHg CPP = MAP − ICP RASS −2 to 0 Lightly sedated to awake and calm…

…marked hypovolaemia, head injury with impaired consciousness, biliary tract disease. There is no contraindication to analgesia in the acute abdomen . The notion that an opioid…

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

…disorders. Patients with severe kidney disease (glomerular filtration rate < 30 mL/min). Patients with mild to moderate heart failure, kidney or liver disease, especially…

…tissue metabolic requirements to exceed available blood flow. The resulting ischaemia threatens skeletal muscle and peripheral nerves and may progress rapidly to irreversible tissue injury…

…penetrating atherosclerotic ulcer, aortic pseudoaneurysm and traumatic aortic injury. In classic dissection, an intimal tear permits blood to enter the diseased aortic media. Blood then…

…formation is associated with poor short term prognosis, although early mortality is usually related to the extent of myocardial injury and its complications—shock, reinfarction…

…MI: MI related to CABG. Type 4b and type 4c events fulfil the criteria for type 1 MI. Procedural myocardial injury may also occur without…

…although descriptions of the syndrome include a broader interval of approximately 1–8 weeks. The pathogenesis is presumed to be immune mediated. Pericardial injury, necrosis…

…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…

…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…

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

…and heart failure are among the conditions associated with myocardial injury. Relationship to chronic coronary syndromes Chronic coronary syndromes (CCS) describe stable period clinical presentations…

…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…

…pulses and capillary refill. Check the skin, and remove rings and jewellery distal to the injury before the swelling develops. Procedure 1. Place the joint…

…manoeuvre. Indications Brief attacks of vertigo, seconds to a minute or so, that are provoked by a change of position — turning over in bed, lying…

…with a high BMI, and that the deltoid injection is placed too high — which causes the shoulder injury known as SIRVA. Both are avoided with…

…ulcers; everything else is supportive. But the same compression applied to a limb with arterial insufficiency can cause necrosis and, in the worst case, amputation…

…surgeon. Dislocation of a native hip (as opposed to a prosthesis) — a high risk of avascular necrosis of the femoral head and of vascular injury…

…be considered. Rhabdomyolysis with marked elevation of CK and threatened kidney injury, as an adjunct to the decisive measure: early and generous fluid administration. The…

…do the job, to reduce urethral trauma. The balloon is filled with sterile water according to the volume printed on the catheter , usually 10 mL…

…coronary syndromes, particularly ST elevation myocardial infarction (STEMI), ischemic injury can disrupt the conduction system at any level, producing atrioventricular (AV) or intraventricular blocks. Isolated…

…uncommon, but their clinical spectrum ranges from transient arrhythmias and minor access site bleeding to myocardial infarction, stroke, coronary perforation, haemodynamic collapse, acute kidney injury…

…as renal failure). To establish a diagnosis of MI, acute myocardial injury must be coupled with clinical evidence of acute myocardial ischaemia. The Fourth Universal…

…Severe elevation Acute HMOD Present Absent clinically Symptoms Often present and related to the affected organ May be absent or nonspecific Treatment setting Usually hospital…

…myocardial injury and troponin elevation but are non ischaemic mimics rather than MINOCA when identified as the final diagnosis. Reported prevalence varies according to the…

…increased, relatively autonomous from angiotensin II and plasma potassium, and resistant to suppression by sodium loading. It is the most common form of secondary hypertension…

…used for type 1 myocardial infarction are fulfilled. The temporal relationship to stent implantation should always be specified. Coronary arterial thrombi are predominantly platelet rich…

Clinical chemistry & laboratory medicine Myocardial ischemia and infarction Definition and pathophysiology Myocardial infarction (MI) is a clinical diagnosis that integrates myocardial injury, evidence of acute…

…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…

…and troponin T (TnT) , which enable the interaction between actin and myosin and are therefore fundamental to muscle contraction. There are cardiac specific isoforms of…

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

…children 24 G Yellow 15–20 mL/min Neonates and small children The flows apply to water by gravity according to the manufacturers' standard measurements…

…of life, contribute to heart failure, and increase the risk of stroke and other thromboembolic events. Subclinical cerebral injury may contribute to vascular dementia, and…

…debris, modern vascular biology has redefined atherosclerosis as a dynamic, immune mediated fibroproliferative response to endothelial injury [2] . The process initiates with endothelial dysfunction, a…

…A normal creatinine can conceal markedly reduced renal function. Acute kidney injury changes clearance from day to day. Reassess the dose daily and follow creatinine…

…injury in whom total brain infarction is judged possible during ongoing ventilation (DBD). An intensive care patient in whom a decision has been made to…

…during airway management , and both are predictable. Indications Inability to protect the airway: reduced level of consciousness, loss of pharyngeal reflexes, vomiting with a risk…

…tumour, primary biliary cholangitis, drugs Mixed Both raised Drug induced liver injury is the commonest cause Isolated bilirubin Unconjugated, the others normal Gilbert's syndrome…

…the pattern of injury or disease, the response to initial treatment and the expected continued bleeding matters more than an exact estimate of blood loss…

…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…

…contraindications to irrigation: A known or suspected perforation of the tympanic membrane — including a history of grommets, ear discharge or pain on contact with water…

…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…

…of permanent neuronal injury increases. Treatment must therefore start at 5 minutes and be escalated without unnecessary pauses [1]. The aims are, simultaneously, to: 1…

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

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

…myocardial wall stress and subendocardial ischemia. Neurohormonal activation and vascular and renal abnormalities contribute to sodium and water retention. The interaction between cardiac and renal…

…intervention (PCI). They evolved from balloon angioplasty and bare metal stents (BMS) in response to restenosis caused principally by neointimal hyperplasia. Contemporary DES combine a…

…BMS). Clinical ISR is generally defined by recurrent symptoms or ischaemic events attributable to renarrowing within the stented segment or at its margins. Angiographic restenosis…