…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…

…The principal pathophysiological determinant of early adverse outcome is acute RV failure. In acute PE, obstruction of pulmonary blood flow increases RV pressure load and…

…Careful electrocardiographic and hemodynamic monitoring with ECG, central vein catheter and intra arterial catheter (A line) is warranted. Overview of vasopressors and inotropes Inotropes and…

…Careful electrocardiographic and hemodynamic monitoring with ECG, central vein catheter and intra arterial catheter (A line) is warranted. Overview of vasopressors and inotropes Inotropes and…

…preservation of adequate right ventricular preload while supporting left ventricular performance and systemic circulation. Improvement in left ventricular function also lowers pulmonary arterial and pulmonary…

…The shunt fraction (Qp/Qs) is a critical hemodynamic parameter used to quantify the ratio of pulmonary blood flow (Qp) to systemic blood flow (Qs)…

…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…

…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…

…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…

…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…

…electrocardiographic and haemodynamic monitoring with ECG, a central venous catheter and an arterial line is necessary to achieve an optimal result. Overview of vasopressors and…

…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…

…of poor vital organ perfusion or frank shock states. In the specific context of perioperative care in patients with pulmonary arterial hypertension (PAH), progression of…

…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…

…reserve, and the increasing burden of comorbid disease. Heart failure with preserved ejection fraction becomes particularly common among the very old. Hypertension, diabetes, atrial fibrillation…

…or another setting that allows frequent blood pressure measurement and continuous monitoring. An arterial line is often appropriate when very rapid or precise control is…

…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…

…and pathophysiology Atrial fibrillation (AF) is a major independent risk factor for thromboembolism, including ischaemic stroke. This risk applies across the clinical patterns of AF…

…of the following: A systolic blood pressure < 90 mmHg caused by the arrhythmia. Ongoing myocardial ischaemia with chest pain and ECG changes. Acute pulmonary…

…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…

…atrial activity. The investigation is diagnostic, not therapeutic. An unstable patient should be cardioverted, not investigated. Contraindications Haemodynamic instability — hypotension, shock, impaired consciousness or pulmonary…

…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…

…activity and there is a chance that ischemic episodes are missed. Indeed, studies (with continuous ST segment monitoring) show that 60% to 75% of ischemic

…Because of this prolonged terminal half life, achieving steady state concentration without a loading dose takes approximately 265 days. Interpatient variability mandates close clinical monitoring…

…in the assessment of myocardial reperfusion The ECG is an invaluable tool to assess whether an occlusion has been resolved and blood flow has been…

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…

…flows and shock profiles. Acid–base and electrolytes in intensive care Neurological monitoring Parameter Target Comment : : : Intracranial pressure (ICP) < 22 mmHg The treatment threshold…

…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…

…establish: Current smoking status. Cigarettes smoked per day. Duration of smoking and cumulative exposure. Previous quit attempts and their duration. Triggers for smoking and anticipated…

…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…