…ECG monitoring (telemetry), which allows instantaneous identification of the initial rhythm ( Thorén et al ). The initial rhythm has immense significance for survival in cardiac arrest…

…of survival. This is because cardiac arrest presenting with ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT) can be defibrillated to restore an organized rhythm…

…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…

Arrhythmias and arrhythmology Pharmacology & dosing Definition and Pathophysiology Sotalol is a nonselective beta adrenoceptor blocker devoid of intrinsic sympathomimetic activity that also prolongs cardiac repolarization…

…disability, exposure (ABCDE) approach is applicable in bradycardia (Figure 1). Cardiac output and blood pressure, rather than ECG, are the strongest predictors of adverse outcomes…

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

…energy shocks outperform low escalating energy protocols. Note that while cardioversion restores sinus rhythm in up to 95% of patients, long term maintenance (particularly in…

…is warranted. Diagnostics Hemodynamic and functional monitoring is central to the safe administration of these agents. Continuous blood pressure and rhythm monitoring are mandatory, particularly…

…of triggers, and reduction of sympathetic drive [4]. Rhythm Stabilization In addition to defibrillation , several pharmacological and interventional alternatives exist to stabilize the cardiac rhythm…

…while awaiting the antidote and specific treatment. Bradyasystole during and after cardiac arrest with persisting electrical activity. Overdrive pacing in bradycardia dependent torsades de pointes…

…reflecting the dynamic interplay between cardiac function and vascular resistance. Advantages of measuring MAP over systolic blood pressure While systolic blood pressure (SBP) indicates the…

…ECMO) initiation ( Soar et al ). ETCO 2 trends can vary during CPR depending on various factors such as the cause of cardiac arrest, compression efficacy…

…instability or cardiogenic shock recurrent or ongoing chest pain refractory to medical treatment life threatening arrhythmias or cardiac arrest mechanical complications of acute myocardial infarction…

…those who did, only a minority had a reduced value — the majority of sudden cardiac deaths occur in patients with preserved LVEF, for whom no…

…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…

…a reassessment of treatment strategies. References O’Mahony C, Jichi F, Pavlou M, et al. A novel clinical risk prediction model for sudden cardiac death…

…not exclude dangerous hyperkalaemia. Record a 12 lead ECG and start cardiac monitoring at a plasma potassium above 6.0 mmol/L, and at lower…

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…

…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…

…made the procedure considerably safer than the blind subxiphoid technique still described in older textbooks. Indications Cardiac tamponade — the only absolute indication, and always urgent…

…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…

…Atrial Fibrillation and Atrial Thromboembolism Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and a profound driver of global cardiovascular morbidity and mortality…

…represents approximately 5–10% of cases. Intermediate high risk PE occurs in haemodynamically stable patients with both RV dysfunction on imaging and elevated cardiac biomarkers…

…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…

…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…

…Contraindications Respiratory arrest, agonal breathing or cardiac arrest — intubate. Inability to protect the airway: a reduced level of consciousness not attributable to hypercapnia, marked swallowing…

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

…branch block. Cardiac monitoring is indicated for patients with a high pretest probability of arrhythmia causing syncope. In hospital monitoring is reserved for those wit

…stabilisation — cardiac arrest, shock, sepsis, major trauma, unconsciousness — until the saturation can be measured reliably. Conditions in which oxygen is given irrespective of the saturation…

…arteries (MINOCA). Ventricular fibrillation and sudden cardiac death are important potential complications. Approximately one third of patients may have severe fixed coronary obstruction. Such patients…

…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…

…mg/mL for local anaesthesia in the awake patient — the anaesthetic also improves the chance of success by counteracting vascular spasm. Pressure monitoring set: stiff…

…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…

…be helpful if ambulatory monitoring fails to capture an event. EPS can thoroughly assess AV conduction and may include the infusion of agents to stress…

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

…Anterior shoulder dislocation The commonest of all dislocations. There is a hollow beneath the acromion, the arm is held in slight abduction and external rotation…

…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…

…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

…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…

…rescue PCI. For the purpose of assessing ST segment return, one should preferably use continuous ST segment monitoring. If monitoring equipment is not available, 12…

…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…

…Heart failure, pulmonary oedema and other conditions with a high risk of fluid overload — a relative contraindication requiring invasive monitoring and slower administration. Significant metabolic…

…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…

…0 g/kg/day Enteral nutrition Started within 48 h where possible Thromboprophylaxis Low molecular weight heparin unless contraindicated Head of the bed 30–45°…

…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…

…careful monitoring and management of modifiable risk factors. The HAS BLED score has demonstrated moderate predictive abilities for bleeding risks in AF patients, regardless of…

…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…

…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…

…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…

…recommended. Warfarin after individual assessment Rule of thumb for the monitoring interval: eGFR divided by 10 gives the number of months until the next check…

…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…

…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…

…functional capacity, and health related quality of life substantially influence both cardiovascular risk and the balance between treatment benefit and harm. Prevention in the very…

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

…dilution instructions and the local protocol before prescribing. Basic principles of treatment The patient should be managed in an emergency department, an intensive care unit…

…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…

…closer monitoring — the patient cannot feel pressure injury Peripheral neuropathy of other cause As above Severe pain Titrate the pressure up gradually Rheumatoid arthritis with…

…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…