…the combined effects of contrast exposure and other ischaemic or nephrotoxic stresses. The kidney is particularly vulnerable to toxic injury because of its high blood…

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

…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…

…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…

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

…to defibrillate immediately if cardiac arrest is witnessed and the rhythm is shockable). This is explained by the fact that there are no means of…

…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…

…insufficient randomised evidence to determine which agent is best. The choice is therefore governed chiefly by the target organ damage, the pharmacology of the drug…

…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…

…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…

…lying still but screams when turned has not finished being titrated. Expect an opioid naive adult to need 5–15 mg of morphine in total…

…loss of function is a tendon injury that was sutured over without being found. Indications A traumatic wound that gapes and cannot be expected to…

…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)…

…limb may already be unsalvageable. Clinical categories ALI is classified according to neurological findings, Doppler signals and the likelihood of limb salvage. Grade Category Sen

…of aorta involved, although the source material does not provide a detailed symptom to anatomy correlation. Pain may be absent, particularly in iatrogenic aortic injury…

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

…can reliably be attributed to acute procedural injury. Even then, it may not be possible to determine precisely how much of the postprocedural increase results…

…of post cardiac injury syndrome (PCIS). PCIS is an umbrella term that also includes post pericardiotomy syndrome and post traumatic pericarditis, including cases related to…

…STEMI) The heart is rotated 30° to the left in the thorax. This positions the basal portion of the left lateral wall posteriorly in thorax…

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

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

…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…

…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…

…immediately. Indications An undisplaced or reduced fracture to be treated conservatively. Immobilisation after reduction of a dislocation. Immobilisation of a ligament injury, a tendon injury…

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

…operator to inject too high. 2. Palpate the acromion . The injection site lies 2–3 fingerbreadths (about 5 cm) below the lower border of the…

…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…

…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…

…marked elevation of CK and threatened kidney injury, as an adjunct to the decisive measure: early and generous fluid administration. The benefit of alkalinisation over…

…urethral injury is suspected. Indications Acute urinary retention. Chronic urinary retention with renal impairment or a large residual volume. A need for accurate measurement of…

…of drug toxicity, such as digitalis excess. Biomarkers and Laboratory Findings The source material does not provide information on biomarkers or laboratory findings specific to…

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

…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…

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

…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…

…it binds the MR, which translocates to the nucleus and induces expression of aldosterone responsive genes. Although the kidney is a major target—where MR…

…platelet rich because they form under high shear conditions. Disruption of an atherosclerotic plaque or injury associated with PCI exposes thrombogenic material, promoting platelet activation…

…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…

…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…

…leading to higher levels of troponin being detected with conventional assays. False positive elevations of troponin are rarely explained by such interference ( Bularga et al…

…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…

…access (absolute, for the bone in question): A fracture of the bone to be punctured, or a major injury proximal to the puncture site. A…

…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…

…by the gradual accumulation of inert cholesterol debris, modern vascular biology has redefined atherosclerosis as a dynamic, immune mediated fibroproliferative response to endothelial injury [2]…

…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…

…infarction is not expected to occur within a reasonable time, and in whom death is judged likely within 180 minutes of treatment being withdrawn (DCD…

…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…

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

…according to local practice. Enteral nutrition and drug administration when the patient cannot swallow safely, for example after a stroke. Sampling of gastric contents and…

…exostoses Narrow and hard to reach Ongoing otitis externa Pain, spread of infection A small or uncooperative child Movement causes injury Preparation and equipment Otoscopy…

…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…

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

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

…al, JAMA Cardiology (2020). Guo et al reported that 27.8% (52 of 187 patients) had myocardial injury, defined as elevated troponin T levels (TnT)…

…formally to reduce heart failure mortality; its established role is symptom relief and prevention of recurrent congestion and hospitalization. Clinical presentation and symptoms Symptoms of…

…procedural safety, reduced repeat revascularization, and broadened the range of lesions amenable to PCI. Stent selection must nevertheless be integrated with lesion anatomy, clinical presentation…

…Intracoronary imaging is encouraged to define the mechanism rather than relying on angiography alone. Factors associated with restenosis The risk of restenosis after metallic stent…