…progressively as kidney function declines and as albuminuria increases. When eGFR falls below approximately 60–75 mL/min/1.73 m², the probability of coronary…

…or III HFrEF, a previous heart failure hospitalisation, sinus rhythm and a heart rate above 70 beats/min. The reduction in the combined outcome of…

…times daily See note Do not use Do not use Nitrofurantoin: as a general rule the drug is contraindicated at an eGFR <45 mL/min…

…pathological Q waves. Pathological Q waves are ≥0,03 s and/or amplitude ≥25% of R wave amplitude in the same lead, in at least…

…risk of respiratory depression. Avoid the combination, or reduce both Red flags and pitfalls A respiratory rate < 8/min, or an increasing level of…

…m/s or a valve area < 1.0 cm² with a mean gradient ≥ 40 mmHg. Fluid responsiveness Static measures such as the CVP predict…

…35 mm. Q waves: pathological Q waves (≥ 0.03 s and/or an amplitude ≥ 25 % of the R wave amplitude in the same lead, in…

…signs of deep vein thrombosis 3 Pulmonary embolism is the most likely diagnosis 3 Heart rate 100/min 1.5 Immobilisation ≥ 3 days or surgery…

…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…

…or nasal polyps (increased risk of hypersensitivity reactions, such as asthma attacks, angioedema, or urticaria with NSAIDs). Alcohol consumption may increase the risk of gastrointestinal…

…unit) or ER (emergency room). Careful electrocardiographic and hemodynamic monitoring with ECG, central vein catheter and intra arterial catheter (A line) is warranted. Overview of…

…pulseless electrical activity (PEA) as the initial rhythm, while the remainder manifest ventricular fibrillation (VF) or asystole ( Ebo et al ). Clinical manifestations of anaphylaxis Nervousness…

…such as MDMA (ecstasy) or amphetamines. In either scenario, there is sustained muscle activation, leading to marked heat generation, acidosis, and the subsequent development of…

…unit) or ER (emergency room). Careful electrocardiographic and hemodynamic monitoring with ECG, central vein catheter and intra arterial catheter (A line) is warranted. Overview of…

…Components of the ATRIA Score The ATRIA score assigns points based on five clinical factors: Anemia: Hemoglobin <13 g/dL in men or <12 g…

…with the onset of physical activity. Profound sinus bradycardia (<30 beats/min or sinus pauses ≥3 s) would warrant further investigation. 6. Which of the…

…or ventricular rhythm (if the rate is <100 beats/min). If more than 30 consecutive beats are premature ventricular contractions it is referred to as…

…Renal function eGFR (mL/min) Management : : 50 Standard dose, creatinine checked at least annually 30 50 Dose reduction as in the table above for rivaroxaban…

…DOAC is given at an eGFR 30 mL/min. At an eGFR of 15–30 mL/min the documentation is inadequate and closer monitoring is…

…otherwise stated. When the weight of a child aged 1–10 years is unknown: estimate it as (age in years + 4) × 2 kg , but use…

…and 5 minutes of compression. Anticoagulant treatment is not in itself a bar to vaccination. Relative: Lymphoedema or previous axillary clearance on the same side…

…μg/kg/min ++++ ++++ ++ +++++ High dose dopamine additionally induces α1 stimulation and thereby vasoconstriction with a marked rise in SVR. As for the intermediate dose…

…that the prescription has no target — the nasal cannula stays in place for days without anyone asking why, or the patient at risk of carbon…

…15 min Ringer's acetate for hypotension or hypoperfusion, usually 500 mL as a rapid bolus, and a smaller bolus where the risk of fluid…

…near normal or mildly reduced kidney function (eGFR 60 mL/min/1.73 m²), potentially leading to misclassification of CKD stages. Population Specificity: The equation…

…used to reduce myocardial ischemia in the CCU or ICU. Time to onset of action 1 minute Duration of action 20 30 minutes Delivery IV…

…May therefore induce or worsen angina pectoris. The rapid reduction of afterload is desired in conditions requiring afterload reduction. Time to onset of action 10…

…difficult. In patients with normal renal function, the occurrence of contrast induced AKI is negligible or very low. Risk rises substantially with chronic kidney disease…

…liver disease, airway or lung disease, and hyperthyroidism; follow up and investigation of the cause of increased flow are appropriate. Exercise PH is defined by…

…Objective assessment of adherence may be undertaken where resources permit, using directly observed treatment or detection of prescribed drugs in blood or urine. The terms…

…hypertension, defined in the cited recommendation as blood pressure ≥140/90 mmHg. Screening is particularly pertinent in the presence of hypokalaemia or treatment resistance. Hypokalaemia…

…fear, pain, anxiety, intense emotion, the sight of blood, unpleasant sights and odors, and orthostatic stress. Situational triggers such as acute hemorrhage, cough, defecation, laugh…

…are the strongest predictors of adverse outcomes. Non acute or asymptomatic bradycardia Non acute bradycardia is a common finding in both healthy and diseased individuals…

…3 mL/min/g of myocardial tissue During hyperemia (maximum stress): Approximately 3.58 ± 1.14 mL/min/g Total hyperemic flow for the whole…

…15 and EPAP 4–5 cmH₂O Increase the IPAP in steps of 2–3 cmH₂O every 5–10 min towards 20–25 cmH₂O according to…

…mm of coved type with a negative T wave in V1–V2. Early repolarisation: J point elevation ≥ 1 mm with notching or slurring in the…

…value As required, in addition to the mealtime dose Never stop basal insulin in a person with type 1 diabetes , not even before fasting or…

…long for thick soft tissue and for the head of the humerus. A pressure bag or a 50 mL syringe with a three way tap…

…25 to 0.5 μg/kg/minute. Increased as necessary (increments of 0.5 μg/kg/min). Maximum dose: 8 10 μg…

…MET) is defined as the amount of oxygen consumed while sitting at rest and is equal to 3.5 ml O2 per kg weight × min…

…causes circulatory compromise or collapse. Causes of tachycardia (tachyarrhythmia) with wide QRS complexes (QRS duration ≥0,12 s) : ventricular tachycardia is the most common cause…

…unipolar pacing, as compared with bipolar pacing. The latter yields a discrete stimulation artifact, which may be visible in one or a few leads. Figure…

…50% renal elimination. • Typically the first choice of drug. • Effective in sinus bradycardia or AV node block. • Dose <0.5 mg may worsen bradycardia and…

…designed to identify ischemic areas of the myocardium by highlighting regions with reduced blood flow. Radiotracers for SPECT Technetium 99m (Sestamibi or Tetrofosmin): With a…

…as a junctional rhythm . The His Purkinje network : All these fibers possess automaticity with an intrinsic rate of depolarization of around 20–40 beats/min…

…due to diminished automaticity (pacemaker function) in the sinoatrial node or conduction defects (e.g. second degree AV block) as a result of ischemia/infarction…

…too costly or invasive to screen a population. The surface ECG is the obvious cheap, standardized, universally available alternative, and it has been mined for…

…slower infusion of 1 mg/min for 6 hours, and then 0.5 mg/min for the remaining 18 hours and subsequent days as necessary…

…LVOT to improve the accuracy of the measurement. Flow velocity in LVOT : Velocity is measured in apical four chamber view (4C) or five chamber view…

…The interpretation is made in the same systematic way as in adults, but against the age specific reference values below. Method of interpretation Heart rate…

…NO) that induces vasodilatation (of both arterioles and veins) via generation of cyclic GMP, which then activates calcium sensitive potassium channels in the cell membrane…

…mg every 5 to 15 minutes as necessary. Continuous infusion: Start infusion at 0.1 mg/min and increase in increments of 0.1 mg…

…tachycardia can exceed 240 beats/min in children. As in sinus rhythm, a P wave precedes every QRS complex and the P wave is positive…

…min At 50 mm/s paper speed, the heart rate is equal to 600 divided by the number of large boxes between two beats. As…

…mechanism of arrhythmia; it is a ventricular conduction disturbance . It is discussed in this chapter because the phenomenon is frequently observed during arrhythmias. As previously…