…of the hand is suitable for finer cannulae. Avoid the lower limb in adults. In shock with collapsed vessels, the antecubital fossa or the external…

…narrow pulse pressure suggests a low stroke volume Capillary refill < 3 s A simple and validated marker of perfusion Lactate < 1.6 mmol…

…is highly dependent on the precision of the Doppler measurement. The Doppler beam must be parallel to the direction of the blood flow (refer to…

…resolved. Capillary measurement of beta hydroxybutyrate has high diagnostic accuracy [2]. A venous blood gas is generally sufficient for the assessment of pH and bicarbonate…

…include: Assessment of all major peripheral pulses. Blood pressure measurement in both arms. Cardiac auscultation. Pulmonary auscultation. Evaluation for heart failure. Assessment for circulatory compromise…

…the maximum arterial pulsatile pressure during systole. With auscultatory measurement, it corresponds to the appearance of the first Korotkoff sound. Diastolic blood pressure: the minimum…

…Capnography refers to the measurement of end tidal carbon dioxide (ETCO 2 ) in the respiratory system. ETCO 2 is the partial pressure of carbon dioxide …

…using pulsed Doppler. Estimating left ventricular filling pressure via e' . Measurement of deceleration time (DT) . Diastolic function can be estimated from E/A ratio, e'…

…employed to evaluate myocardial perfusion by measuring the intensity of their uptake within the myocardium. Furthermore, certain radiotracers enable direct measurement of coronary blood flow…

…with its most common waveforms. Important intervals and points of measurement are depicted. ECG interpretation requires knowledge of these waves and intervals. The P wave…

…high Lp(a) level may lead to substantial underestimation of cardiovascular risk. Conversely, Lp(a) measurement provides limited additional reclassification beyond currently recommended global risk…

…end of diastole and 40 ml is pumped out during systole, then the ejection fraction is 40%. Thus, the ejection fraction is the stroke volume…

…25% Normal FS, 2D measurement 18% Advantages of fractional shortening If ventricular geometry is normal and there are no regional wall motion abnormalities, then fractional…

…with its most common waveforms. Important intervals and points of measurement are depicted. ECG interpretation requires knowledge of these waves and intervals. The P wave…

…measurement in evaluating aortic root morphology. Age stratified formulas help determine expected normal values based on body surface area (BSA), aiding in the diagnosis of…

…preferably confirmation by home measurement or 24 hour recording — the thresholds for which are lower than for office measurement. Classification of office blood pressure Category…

…dialysis catheter, not an ordinary triple lumen catheter). Measurement of central venous pressure and central venous oxygen saturation. Repeated blood sampling during intensive care. Exhausted…

…the diameter is greatest (usually halfway through systole). Zoom in LVOT to improve the accuracy of the measurement. Flow velocity in LVOT : Velocity is measured…

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…

…e.g left ventricular diameter, are evaluated in several views in order to assess the reliability and reproducibility of the measurements. The parasternal and apical…

…Insert a urinary catheter and start hourly urine output measurement. 5. Give a bolus of sodium bicarbonate 1–2 mmol/kg intravenously in symptomatic salicylate…

…at the end of expiration, with the tape horizontal and without compressing the skin. Ratios and other measurements Measurement Calculation Threshold : : : Waist–hip ratio Waist…

…aphasia and radiological changes resembling ischaemic stroke. Glucose measurement is therefore always part of the initial stroke assessment [1]. Treat immediately when there are symptoms…

…coach actively, and do not accept a trace you would not be prepared to show a colleague. Indications Investigation of chronic cough, dyspnoea, wheeze or…

…should include: palpation of peripheral pulses; auscultation for carotid, femoral, and abdominal bruits; bilateral brachial blood pressure measurement; cardiac auscultation; inspection of the legs and…

…hemodynamic parameter used to quantify the ratio of pulmonary blood flow (Qp) to systemic blood flow (Qs). This measurement is pivotal in diagnosing and managing…

…How to measure the QT interval Measurement of the QT interval may be difficult due to T wave changes. Causes of prolonged QTc duration Antiarrhythmics …

…with a subsequent measurement of 40% [14] . This distinction is paramount for practicing cardiologists: HFimpEF represents a state of myocardial remission rather than true recovery…

…types of heart failure: HFPEF , HFmrEF and HFREF . This classification is based primarily on the measurement of left ventricular ejection fraction (LVEF). The majority of…

…types of heart failure: HFPEF , HFmrEF and HFREF . This classification is based primarily on the measurement of left ventricular ejection fraction (LVEF). The majority of…

…be regarded as a series of completely discrete diseases. Heart failure extends across the full range of LVEF, and echocardiographic measurement is subject to meaningful…

…since the speed of ultrasound is constant in the body. The investigator specifies where the measurement should be performed by moving the sample volume (SV…

…should be small — a few tenths of a millilitre, at most about 0.5 mL. A larger volume draws in peripheral blood and dilutes the…

…area of the LVOT, as illustrated in Figure 1. Figure 1. Calculation of stroke volume in the LVOT, using pulsed wave Doppler and measurement of…

…still and lowered at each measurement, and not to talk. Otherwise ordinary activities, including work. No showering or bathing. A diary of going to bed…

Echocardiography Tissue Doppler (Tissue Velocity Imaging) Previous chapters on Doppler imaging have all focused on measurements of blood flow. However, the Doppler effect can also…

…hypoxia, drug withdrawal and incorrect blood pressure measurement must be corrected before treatment is intensified [1,2]. The evidence that any particular intravenous drug improves…

…case add toe pressure measurement. Absolute: ABI < 0.5 or toe pressure < 30 mmHg. Decompensated heart failure — compression of both legs acutely increases…

…variable and echocardiographic measurement has meaningful variability. Patients with LVEF 40% have substantial morbidity and mortality, despite often having a greater burden of cardiovascular and…

…since they compare electrical currents in two measurement points. The electrophysiological basis of the ECG leads The movement of charged particles generates an electric current…

…of breathing Accessory muscle use Cyanosis, exhaustion, hypotension or collapse The classification is based on a combination of clinical findings, oxygenation and objective measurement of…

…in haematological malignancy. Investigation of dementia with biomarkers (amyloid, tau, phospho tau). Measurement of the opening pressure in suspected idiopathic intracranial hypertension. Therapeutic drainage in…

…retention. Chronic urinary retention with renal impairment or a large residual volume. A need for accurate measurement of urine output in a critically ill patient…

…through the orifice itself. This implies that PISA can be used to quantify regurgitation volume. In the case of mitral regurgitation (MR), the regurgitant area…

…Drug Standard dose Reduced dose and criterion : : : Apixaban 5 mg twice daily 2.5 mg twice daily if at least two of: age ≥80 years…

…whom non invasive measurement is unreliable: marked obesity, pronounced vasoconstriction, arrhythmia, intra aortic balloon pump. Assessment of stroke volume variation as part of fluid management…

…of the chosen finding — measurement, photograph or video. 3. Give atropine 0.5 mg intravenously (alternatively glycopyrronium 0.2 mg) to reduce the risk of…

…ala of the nose over the earlobe to the middle of the sternum. The depth is usually around 30–40 cm. Mark the measurement on…

…null The current ERC and ESICM recommendation is continuous core temperature measurement and the active prevention of fever — defined as a temperature above about 37…

…12 lead ECG Initial hs cTn measurement Continuous cardiac monitoring The source material does not provide a detailed list of physical examination findings or a…

…U waves that are fused with the T wave should be included in the measurement. This may result in an overestimation of the QT interval…

…apply to the anti inflammatory effect. They say nothing about the mineralocorticoid effect or about suppression of the HPA axis, where a long half life…

…airway, breathing, circulation and level of consciousness. 2. Attach ECG, pulse oximetry and repeated blood pressure measurement when a hypertensive emergency is suspected. 3. Insert…

…7. Start a fluid balance chart and hourly urine measurement. Sudden polyuria is a warning sign of impending overcorrection. Grading Hyponatraemia is defined as a…

…a high risk of hypoglycaemia 8–12 mmol/L The critically ill patient in intensive care According to the local protocol Avoid tight targets in…

…fluid and lactate measurement. A meta analysis of emergency department alert systems found an association with lower mortality, but most of the evidence was observational…

…include consideration of treatable contributors, such as underlying comorbidities, supervised muscle strengthening physiotherapy, exercise, and coordination and balance training. Orthostatic Blood Pressure Measurement Before starting…

…pressure measurement; White coat hypertension; Poor adherence or persistence with prescribed therapy; Inadequate dosing; An inappropriate diuretic for kidney function; Excess dietary sodium and volume…

…continued, dosing is guided by drug concentration measurement. At a creatinine clearance <20 mL/min, consider an alternative treatment In aminoglycoside treatment of obese patients…

…Quantification of blood flow using PET Quantitative PET perfusion imaging offers precise measurements of myocardial blood flow in milliliters per minute per gram of tissue…