…to not disturb the patients' rest. It was believed that the mere presence of physicians and nurses caused harmful stress. Approximately 30% of patients died…

…the heart rate exceeds 100 beats per minute. Although sinus tachycardia is the most common tachyarrhythmia, it may not always be straightforward to diagnose on…

…become calm, quiet in the chest and stopped struggling may be about to stop breathing. Diminishing wheeze means improvement only if air entry, speech, work…

…However, current guidelines do not consider this fact (beyond the recommendation to defibrillate immediately if cardiac arrest is witnessed and the rhythm is shockable). This…

…do it. Otherwise the echocardiographic findings plus the clinical picture are sufficient for a treatment decision. Systemic thrombolysis is the first line treatment in high…

…The standard deviation for maximum heart rate is around 10 beats per minute, which means that if the expected maximum heart rate is 160 min…

…the more efficient the pumping mechanism. Sequential activation means that the atria activate first, filling the ventricles with adequate volumes of blood before the ventricles…

…does not possess automaticity, but cells surrounding it do. These cells are capable of generating an escape rhythm with a rate of 40 beats per…

…al ). Current guidelines recommend a compression depth of 5–6 cm at a rate of 100–120 compressions per minute (Figure 1). These recommendations are…

Procedurer The value of the exercise test lies not in ST depression alone but in the overall picture : exercise capacity, symptoms, blood pressure response, heart…

…is inhibited, the resulting accumulation of these peptides irritates afferent neural pathways in the respiratory tract. This process is not dose dependent. Similarly, angioedema occurring…

…with physical activity, a large meal, emotional upset, or cold exposure. The absence of chest pain does not exclude clinically important CCS. Silent or minimally…

…95 % of a healthy reference population, which means that one healthy value in twenty falls outside them . Order twelve tests in a healthy person and…

…which means that the pacemaker stimulations do not result in myocardial activation. Failure to pace (FTP) , which means that the pacemaker does not stimulate as…

…gas describes the physiology at the moment of sampling, but does not by itself identify the cause. The result must always be weighed together with…

…17 mm/m2 Aortic arch 22 36 mm Descending aorta 20 30 mm ​Indexing means that the value is adjusted for body surface area (BSA)…

…crisis [1,2]. A hypertensive emergency means a markedly raised blood pressure together with ongoing or new organ damage in which immediate, controlled blood pressure…

…assessment [1]. Treat immediately when there are symptoms and a low glucose. Do not wait for the venous laboratory result. 1. Assess and stabilise the…

…insulin to a patient who is not eating. Give it after the meal when the food intake is uncertain. Not writing the prescription for hypoglycaemia…

…Lowering the body temperature to 33 °C has not been shown to improve survival or the neurological outcome compared with keeping the patient normothermic — but…

…Site is maintained and updated actively, which means it deserves a bookmark if your into anasthesia or critical care medicine. Critical Care Reviews Dr Rob…

…often have severe multivessel coronary disease and progressive, “piece meal” necrosis extending beyond the original infarct zone. Coronary Occlusion and Myocardial Injury STEMI generally results…

…end tidal carbon dioxide level. Continuous ETCO 2 monitoring is possible by means of intubation and ventilation devices equipped with sensors. A normal capnogram is…

…can potentially be reversed if interventions are promptly instituted. In scenarios where an antidote is not available, it is essential to provide supportive care and…

…an electrical current. This means that the propagation (spread) of the action potential is equal to the spread of an electrical current. All tissues and…

…which means that it should be flat and on the same level as the baseline (recall that the baseline is the level of the PR…

…coronary artery occlusion is located. The term culprit – which means "the guilty one" – is used to denote the occluded coronary artery. In the majority of…

…testing must not be performed within 4 to 6 days after acute myocardial infarction. Moreover, early exercise tests should not be maximal, which means that…

…Life Support (ECLS) encompasses several extracorporeal systems designed to assist in cases of cardiac or respiratory failure by means of an extracorporeal pump and oxygenator…

…exceptions. Prior to the Doppler era, hemodynamic assessments were performed by means of right heart catheterization (with Swan Ganz catheter [ pulmonary artery catheter ]). However, hemodynamic…

…or indeed the disease itself, is excited more especially upon walking up hill, and after a meal; that thus excited, it is accompanied with a…

…etc .) are warranted. Management of AV blocks aims to restore atrioventricular conduction either pharmacologically or by means of artificial pacemakers. Both methods may be used…

…Accessory pathways do not display the slow conduction that the atrioventricular node does, and this means that any impulse reaching the accessory pathways may travel…

…The conditions encircled by the term sinus node dysfunction are as follows: Sinus bradycardia (which in its purest form means that the automaticity is diminished)…

…and yield a longitudinal shortening (Figure 1A), which means that the base is pulled towards the apex. Myocardial fibers in the middle layer (mid wall…

…π × radius 2 , where radius = diameter/2 ), and velocity is measured by means of Doppler (Figure 1). Figure 1. Calculating flow through a cylinder…

…to diastolic function. High compliance is desirable and means that the ventricle is capable of filling rapidly while operating at low end diastolic pressure. EDV …

…by the clinical response and by repeated laboratory measurements, not by the values on admission alone. Diagnosis Current diagnostic criteria According to the international consensus…

…does not regain its mechanical function until days to weeks have passed — atrial stunning — which means that the thromboembolic risk is greatest after, not during…

…6. Observe for 10 minutes and check the pharynx — blood running down into the pharynx means that the bleeding is not controlled. Petroleum jelly gauze…

…or in the wind. Suspected corneal abrasion. A red eye where the diagnosis is not obvious. Suspected acute glaucoma (tonometry). Contraindications Absolute contraindications to instrumental…

…Contact your national or regional poison control centre before you decide, not afterwards. Indications Medicinal charcoal is given after the ingestion of a potentially toxic…

…syringe and inject. The injection should go in easily. Resistance means the tip is in tissue, not in the joint cavity. 6. Withdraw the needle…

…the floor of the nose, parallel with the palate and straight backwards , not upwards towards the bridge of the nose. 7. When the tip reaches…

…48 hours Smoking 1 hour Vigorous physical exertion 30 minutes A large meal 2 hours Withholding applies only to diagnostic spirometry with a reversibility test…

…which means the haemoglobin can be normal before fluid has redistributed or been given. In massive bleeding, the decision to transfuse must therefore not be…

…What determines whether the treatment is safe is not the starting dose but the system around the patient : that the weekly dose is adjusted in…

…Consequently, obesity is only one pathway through which diet affects cardiovascular health; dietary changes can improve cardiometabolic risk factors within 6–8 weeks even without…

…the configuration of the fetal circulation; pulmonary resistance is high (which means that resistance in the pulmonary artery is high), whereas resistance in the systemic…

…versa ( Figure 17 ). Otherwise there is discordance (opposite directions of QRS and T) which might be due to pathology. A negative T wave is also…

…Unhealthy diet. Cerebral / peripheral vascular disease. Cancer. Acute coronary syndromes cause symptoms already at rest. Stable ischemic heart disease does not cause symptoms at rest…

…has deteriorated into PEA or asystole, and therefore the worse the prognosis. This does not always hold true. For example, in cardiac arrest due to…

…demonstrates that the majority of patients will not survive post resuscitation care. Among those who survive to hospitalization, 50 65% die within 24 hours ( Soar…

…are based on conventional 12 lead ECG. Established ECG criteria do not apply to mathematicallyderived 12 lead ECGs (e.g EASI, Frank's leads etc)…

…repolarization syndrome . Early repolarization pattern may actually not be due to early repolarization The term "early repolarization" was used to describe the ECG pattern. Indeed…

…varies with respiration. Lead III may also display small Q waves (not related to respiration) in individuals with electrical axis 30° to 0°. QS complex…

…Ejection fraction is routinely examined at rest, which does not reveal the functional (maximum) capacity of the left ventricle, as this would require measuring the…

…stroke volume cannot increase further, which means that a further increase in cardiac output depends on an increase in heart rate. As illustrated in Figure…

…the deviation of the electrical axis. The QRS duration is slightly prolonged but does not reach 0.12 s. Block in the anterior fascicle causes…

…ventricular hypertrophy under normal loading conditions. Hypertrophic cardiomyopathy should not be confused with hypertrophy caused by increased loading conditions. Increased ventricular load is mostly caused…