…brachial index (TBI). The digital arteries rarely calcify, which makes toe pressure the method of choice in diabetes and renal failure. A normal TBI is ≥

…undernutrition in adults Calf circumference Largest circumference < 31 cm is a screening marker for sarcopenia Body composition Measurement Women Men : : : Body fat, normal 21…

…profiles in shock Type CO SVR CVP/PCWP ScvO₂ : : : : : : : : : Hypovolaemic ↓ ↑ ↓ ↓ Cardiogenic ↓ ↑ ↑ ↓ Distributive (septic) ↑ or normal ↓↓…

…halve before the creatinine leaves the reference range, because the relationship is hyperbolic. In people with a low muscle mass — the elderly, the undernourished, amputees…

…echocardiographic parameters to calculate an individual's risk of SCD over the next 5 years. The calculator is widely used in clinical practice and is…

…with diabetes and carotid atherosclerosis tends to be more advanced than in people without diabetes. Carotid disease is also a marker of systemic cardiovascular risk…

…min/1.73 m², cardiovascular mortality risk may be as much as three times higher than in individuals without comparable renal impairment. The cardiovascular burden…

…are available. Further diagnostic imaging solely because calcified plaque is present in an asymptomatic individual is not supported by the available evidence described here. Systematic…

…DASH style diets. Their effects are multidimensional and cannot be adequately inferred from changes in a single intermediate marker such as cholesterol. Dietary composition may…

…ECG, and normal initial troponin may be observed in a chest pain unit or another non intensive care setting while serial testing is completed. Diagnostic…

…segment elevations Rapid T wave inversion Normalization (return) of ST segment elevations Successful reperfusion results in rapid and marked normalization (return) of ST segment elevations…

…concentrate it. In older, malnourished, amputee or muscle wasted patients, an apparently normal creatinine may therefore correspond to markedly impaired renal function [3]. Urine output…

…20 % Normal Non dipper < 10 % Independent risk marker Reverse dipper ≤ 0 %, night time pressure higher than daytime The highest risk in the group Extreme…

…minutes of standing in older patients, patients with diabetes and anyone with dizziness Definitions White coat hypertension: a raised office reading but normal readings at…

…Definition and pathophysiology Acute limb ischaemia (ALI) is an abrupt reduction in arterial perfusion of an upper or lower limb that causes tissue metabolic requirements…

…singly or in combination. Syncope is particularly important as a marker of potentially severe disease. The presence of haemodynamic instability places the patient in the…

…suppression is maintained. A change in antiretroviral therapy is not recommended in individuals with previous virological failure if it risks loss of suppression. Clinical presentation…

…coexistence of defined clinical and laboratory components; the diagnostic criteria themselves are not reproduced in the available source material. Waist circumference is particularly important because…

…the index marker is used to determine left and right in the obtained image. Figure 1 illustrates how the index marker is used for orientation…

…stunning . This is a protective mechanism since the cessation of contractions leads to a marked reduction in cell metabolism and thus prolongs survival. Myocardial stunning…

…structure located to the right of the index marker will be shown on the right side of the corresponding image marker in the ultrasound image…

…reperfusion and in that scenario it is a good prognostic marker because it signals that coronary blood flow has been restored. Note that in that…

…asymptomatic, NSVT serves as a critical marker of arrhythmogenic risk, particularly in the setting of ischemic heart disease or reduced left ventricular ejection fraction (LVEF)…

…BNP (NT proBNP) are circulating markers of myocardial wall stress. They are released principally by ventricular cardiomyocytes in response to increased transmural stress and ventricular…

…particularly in patients with marked tolerance. The most important measures in severe or complicated withdrawal are: 1. A benzodiazepine in a sufficient and repeated dose…

…axis, where a long half life produces more marked suppression. Stress dosing in known adrenal insufficiency A patient with primary adrenal insufficiency (Addison's disease)…

…several non pharmacological measures at the same time, and use drugs only in severe agitation or marked distress. Delirium is an acute neuropsychiatric syndrome and…

…order in which measures are taken and the principles that are common to all protocols. Children, pregnant women and patients with advanced renal failure, marked…

…al ). In the United States, more than 500,000 individuals (adults and children) experience a cardiac arrest (Heart Disease and Stroke Statistics). The CARES registry…

…NSTEMI and unstable angina. Management begins in parallel with the diagnostic work up. Obtain an interpretable 12 lead ECG within 10 minutes of first medical…

…five levels, with mild skin and mucosal reactions in the lower grades and marked airway, respiratory or circulatory compromise in the higher ones [5]. For…

…complication rate. The femoral artery is the second choice and is often the best in marked shock or during high dose vasopressor treatment, when the…

…not given another hour. Indications CPAP: Acute cardiogenic pulmonary oedema with hypoxaemia and marked work of breathing — the strongest indication, with a rapid effect on…

…recent stroke or TIA in the vertebrobasilar territory. Retinal detachment. Relative: Marked cervical restriction of movement or pain — use the Semont manoeuvre or the side…

…5–10 minutes after the injection . 7. Stop the test in the event of bradycardia, bronchospasm, marked salivation or increasing weakness, and give atropine. 8…

…An unsecured airway or haemodynamic instability — stabilise the patient first. Marked septal deviation towards the bleeding side (relative). Preparation and equipment Personal protective equipment (gloves…

…Within a day or so Unilateral, foul smelling nasal discharge in a small child is a foreign body until proven otherwise. Contraindications Absolute: that you…

…urine output and ask when the patient last passed urine. Contact intensive care in circulatory compromise, serious arrhythmia, marked QRS widening, a sine wave pattern…

…hypersensitivity to the preparation. Intramuscular injection in marked coagulopathy or thrombocytopenia (< 50 ×10⁹/L) — choose the subcutaneous route if possible, otherwise give IM with…

…pain or restricted movement (therapeutic aspiration). Intra articular corticosteroid injection in verified inflammatory or osteoarthritis related joint disease. Contraindications Infection of the skin or soft…

…abscess, marked swelling, previous radiotherapy. In the "can't intubate, can't oxygenate" situation there are no contraindications — a laryngeal mask is inserted even with…

…the right place. In suspected bacterial meningitis it is the time to antibiotics that saves the patient — the puncture must never delay it. Indications Suspected…

…Suspected base of skull fracture or a marked midfacial fracture — the tube can pass through a fracture in the cribriform plate into the cranium Absolute…

…atrium. An electrode placed in the oesophagus at the right level therefore records atrial depolarisation with an amplitude the surface ECG can never achieve, and…

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

…the condition has been corrected Marked coagulopathy or thrombocytopenia Routine plasma or platelets are not needed — the INR does not predict bleeding risk in paracentesis…

…suggests a raised filling pressure Marked respiratory variation in mitral and tricuspid inflow The echocardiographic counterpart of pulsus paradoxus Contraindications In overt tamponade with shock…

…A limb with paresis or marked swelling. A vein suspected of thrombosis or previously thrombophlebitic. Intraosseous access (absolute, for the bone in question): A fracture…

…four parallel components: supportive treatment, a targeted antidote, reduced absorption and, in selected cases, enhanced elimination. For many poisonings, well delivered supportive treatment matters more…

…result can be interpreted. What decides that is whether the patient is taking a steroid that cross reacts in the cortisol assay, whether the samples…

…test in: Condition Recommended delay : : Myocardial infarction or unstable angina 1 month Pneumothorax 1 month after resolution Pulmonary embolism, until anticoagulated and stable An individual…

…precipitate ventricular fibrillation. Prioritise rewarming. Bradycardia in a patient with a normal circulation and no symptoms requires no pacing, only monitoring and preparedness. Asystole with…

…3. Correct the hypokalaemia. Aim for a serum potassium in the upper normal range, around 4.0–4.5 mmol/L, and continue replacement throughout…

…clinically significant bleeding. Pregnancy in the first trimester and close to delivery (embryopathy and fetal bleeding respectively). Marked liver failure with coagulopathy. Severe uncontrolled hypertension…

…infarction. IIa B Routine blood sampling for serum markers is indicated as soon as possible in the acute phase but should not delay reperfusion treatment…

…by the left ventricle. This explains why leads V4–V6 normally displays large R waves in adults (refer to The Normal ECG). The fetal circulation…

…Hormonal influences, including oestrogen and progesterone related structural changes in the coronary media. The early postpartum period, when marked hormonal changes occur. Hypertension and oestrogen…

…50% ( Eleid et al ). The cause of aortic stenosis displays marked geographical variations. In high income countries, the majority of cases are caused by calcification…

…an idiosyncratic response to substances such as MDMA (ecstasy) or amphetamines. In either scenario, there is sustained muscle activation, leading to marked heat generation, acidosis…

…rates and case fatality in coronary artery disease peaked in the 1970s and have declined steadily ever since. The marked decline in death rates and…