…effect. Increases coronary blood flow. Atrial or ventricular arrhythmias Bradycardia Peripheral (digital) ischemia Hypertension (especially nonselective β blocker patients) Prolonged use may be cardiotoxic. Epinephrine…

…effect. Increases coronary blood flow. Atrial or ventricular arrhythmias Bradycardia Peripheral (digital) ischemia Hypertension (especially nonselective β blocker patients) Prolonged use may be cardiotoxic. Epinephrine…

…presence of obstructive coronary artery disease (CAD), in non obstructive coronary arteries, or in patients with intermediate lesions that do not produce physiologically significant flow…

…A MAP of approximately 60 to 65 mmHg is generally considered the minimum threshold necessary to ensure sufficient blood flow to vital organs such as…

…and/or low arterial oxygen saturation Syncope These findings may occur singly or in combination. Syncope is particularly important as a marker of potentially severe…

…a mask with a reservoir, a Venturi mask with a set of valves, and a high flow nasal cannula where available. Bag mask equipment for…

…low output, or persistent severe symptoms require close monitoring and consideration of invasive haemodynamic assessment when precise measurements are needed to guide therapy. Diagnostics Electrocardiography…

…atrial appendage (LAA). The LAA is a highly trabeculated, windsock like embryonic remnant that exhibits uniquely low flow velocities during the loss of organized atrial…

…Post Intervention Monitoring : Assess residual shunts after device closure or surgery. Differentiating Pathologies : Helps differentiate cardiac vs. non cardiac causes of symptoms like dyspnea or…

…category of elevated blood pressure, defined as office SBP 120–139 mmHg or DBP 70–89 mmHg. This distinction supports a risk based approach because…

…by heart is that an arterial line must never be confused with a venous access. Indications Continuous blood pressure monitoring in haemodynamic instability or during…

…Discharge Management The STRONG HF trial demonstrated the safety and efficacy of an approach based on starting and titrating oral medical therapy for heart failure…

…after arterial puncture, technically more difficult with ultrasound Femoral vein Fastest, and does not interfere with ongoing CPR or airway management, no risk of pneumothorax…

…care or coronary care unit, and the operating theatre. Careful electrocardiographic and haemodynamic monitoring with ECG, a central venous catheter and an arterial line is…

…with a high risk of fluid overload — a relative contraindication requiring invasive monitoring and slower administration. Significant metabolic alkalosis or an arterial pH above 7…

…Prevention of recurrence after a healed venous ulcer. After deep vein thrombosis with post thrombotic syndrome. Differential diagnosis Feature Venous ulcer Arterial ulcer Diabetic foot…

…vasoconstriction may occur, accompanied by decreased venous capacitance and an elevation in right atrial pressure. Levosimendan represents a distinct class of inodilator. It enhances myocardial…

…Fluid and monitoring Use a balanced crystalloid in the first instance. Give small boluses, for example 250 to 500 mL, with immediate reassessment of the…

…90% of prevalent hypertension. Hypertension has a major population attributable contribution to chronic coronary disease, cerebrovascular disease, and peripheral arterial disease. More than 70% of…

…a coronary care unit or another setting that allows frequent blood pressure measurement and continuous monitoring. An arterial line is often appropriate when very rapid…

…bundle branch block in acute anterior infarction, and before drugs or procedures with a known risk of bradycardia. Transvenous pacing is chosen when the need…

…infusions. A ventilator, an arterial line, a central venous catheter, ECG monitoring, blood gases. Drugs for sedation, analgesia and control of shivering. Procedure 1. Start…

…index of AV nodal conduction, but does not significantly alter the H V interval. By these mechanisms, it slows the ventricular response to atrial tachyarrhythmias…

…pressure ECG monitoring D Disability AVPU: Alert Voice responsive Pain responsive Unresponsive Limb movements Pupillary light reflexes Blood glucose E Exposure Identify signs of heart…

…ECG and longer rhythm monitoring Indications Palpitations, presyncope or syncope of suspected arrhythmic origin. Assessment of rate control in atrial fibrillation. Suspected paroxysmal atrial fibrillation…

…Consequently, the absence of AF during intermittent monitoring is not sufficient evidence that thromboembolic risk is low. In the setting of acute coronary syndrome, AF…

…dose in atrial fibrillation Criteria for dose reduction according to FASS : : : Apixaban 5 mg × 2 2.5 mg × 2 if at least two of: age…

…etomidate), routine blood pressure and oximetry monitoring, availability of atropine, isoproterenol, or transcutaneous pacing for post shock bradycardia, and use of biphasic defibrillators , which are…

…widely recognized and validated tool used to assess the one year risk of major bleeding in patients with atrial fibrillation (AF) who are taking anticoagulants…

…to restart it after the procedure. Document the restart date in the medical record. Sources ESC Guidelines for the management of atrial fibrillation. Internetmedicin, DOACs…

…lidocaine gel for the electrode. A glass of water with a straw, a vomit bowl, tissues, suction. Monitoring with ECG, blood pressure and saturation throughout…

…For instance, an increase in left atrial size or the development of NSVT may warrant closer surveillance or a reassessment of treatment strategies. References O…

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

…visible, it is retrograde in lead II (because of the reversed direction of atrial activation) and may be located before or after the QRS complex…

…Intermediate–high Stable Yes Raised Admission with monitoring. Be prepared for rescue thrombolysis Intermediate–low Stable One of the two positive Admission Low Stable No…

…explain the marked differences in characteristics and outcomes across the data sources for out of hospital cardiac arrest (OHCA) and in hospital cardiac arrest (IHCA…

…monitoring should start immediately and a defibrillator must be ready. I B Consider connecting leads V7, V8 and V9 in patients with high suspicion of…

…a high risk of avascular necrosis of the femoral head and of vascular injury; always an orthopaedic surgeon, and usually general anaesthesia. An open dislocation…

…absence of malfunction, a pacemaker should have been checked within the preceding 12 months and an ICD within the preceding 6 months. Remote monitoring may…

ECG Myocardial ischemia and infarction Use of ECG in acute coronary syndromes & chest pain patients An ECG must be performed on all patients seeking medical…

…correlates best with total cumulative dose—may be a better predictor of long term tolerability. Hemodynamic Effects Amiodarone acts as a peripheral and coronary vasodilator…

…and this confirms that the coronary artery flow is patent. The rapid ST segment return is explained by rapid normalization of myocardial cell membrane potentials…

Procedurer What determines the outcome of an emergency intubation is rarely the laryngoscopy itself but what was done before it: how well the patient was…

…continuous ECG monitoring and early assessment of the need for dialysis ECG changes or serious neuromuscular symptoms mean a high risk even if the plasma…

…monitoring, intravenous or intraosseous access, a targeted history At 5 minutes A full, adequate dose of a benzodiazepine About 10 minutes Repeat the benzodiazepine once…

…in hospital cardiac arrest (IHCA) 20 30% of victims have continuous ECG monitoring (telemetry), which allows instantaneous identification of the initial rhythm ( Thorén et al …

…pressure Marked respiratory variation in mitral and tricuspid inflow The echocardiographic counterpart of pulsus paradoxus Contraindications In overt tamponade with shock there are no absolute…

…ECG monitoring. Fluid where hypovolaemia is likely, but avoid repeated blind boluses in cardiogenic toxic shock D Plasma glucose immediately. Assess the level of consciousness…

…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…

…of seizures, delirium tremens, infection, trauma and metabolic disturbance. 4. Monitoring at the appropriate level of care , with readiness for respiratory support. 5. Treatment of…

…acute coronary syndrome See the circulatory and haemodynamic parameters for pressures, flows and shock profiles. Acid–base and electrolytes in intensive care Neurological monitoring Parameter…

…monitoring, complications and when thrombectomy should be considered. The doses and Swedish thresholds below are based on the national guideline for the management of reperfusion…

…with the diagnostic work up. Obtain an interpretable 12 lead ECG within 10 minutes of first medical contact, attach continuous rhythm monitoring, secure intravenous access…

…marked work of breathing — the strongest indication, with a rapid effect on dyspnoea and oxygenation. Atelectasis and postoperative hypoxaemia. Hypoxaemic failure where high flow nasal…

…smoking After acute coronary syndrome Reinfarction reduced by approximately 30–40%; death reduced by approximately 35–45% Peripheral artery disease Lower risk of progression to…

…stenosis. Diagnostics Electrocardiogram and Cardiac Monitoring An ECG should be performed if there is suspicion of syncope due to an arrhythmia or underlying cardiac disease…

…Contraindications Ongoing respiratory depression, or untreated severe respiratory failure without the possibility of monitoring. Paralytic ileus and suspected obstructive ileus (an opioid can be given…

…ECG monitoring and access to airway support. Indications Clinically suspected myasthenia gravis in a patient with clear, objectively verifiable fatigable symptoms. Assessment of whether residual…

…but do not delay treatment of a neurologically compromised patient. Continuous glucose monitoring reflects interstitial glucose and lags behind the blood glucose during rapid changes…

…the first dose of antibiotic, the cultures, the fluid bolus and the start of the vasopressor. Time Action : : 0 to 5 min ABCDE, continuous monitoring…