…and shock, where perfusion may be compromised. Hemodynamic determinants of MAP Hemodynamically, MAP is influenced by cardiac output (CO) and systemic vascular resistance (SVR), as…

…systemic and pulmonary vascular resistance, and restore adequate end organ perfusion. Dobutamine is a synthetic catecholamine that functions as an agonist of both beta1 and…

…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…

…an emergency management pathway. Patients without haemodynamic instability require more detailed prognostic evaluation using two complementary domains: Indicators of acute PE severity , including clinical findings…

…flow limitation. The mechanisms are incompletely defined. Proposed contributors include hypercontractility or hypersensitivity of coronary vascular smooth muscle to vasoconstrictor stimuli, including adrenergic agonists, leukotrienes…

…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…

…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…

…al ). The incidence of treated cardiac arrests outside hospitals (OHCA) is about 70 cases per 100,000 person years in Europe ( EuReCA One, Benjamin et…

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

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…

…of ventilation, metabolic activity, and perfusion. Increased aerobic metabolism, perfusion, and ventilation result in a higher end tidal carbon dioxide level. Continuous ETCO 2 monitoring…

…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…

…and should be managed urgently. The risk of cardiogenic shock and cardiac arrest is high and pharmacological interventions are frequently futile. It is often necessary…

…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…

…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…

…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…

…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…

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…

…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…

…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…

…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…

…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…

…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…

…ganglion block (SGB) or cardiac surgical sympathetic denervation can be performed to mechanically reduce sympathetic output [4]. Evaluation of Treatment and Alternatives for Drug Failure…

…the investigation will be usable. Ambulatory blood pressure monitoring (ABPM) Indications Confirmation of newly detected hypertension — recommended before treatment is started . Suspected white coat hypertension…

…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…

…relation to ACE inhibitor therapy. Biomarkers and Laboratory Findings Monitoring renal function and potassium is a critical component of ACE inhibitor therapy. Blood pressure (including…

…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

…Ambulatory blood pressure monitoring (ABPM): automated measurement, usually over 24 hours, at predefined intervals. Inter arm difference: a sequential systolic difference of 10 mmHg between…

…a better marker of reperfusion than angiography itself. Studies have shown that angiographic blood flow does not always correlate with myocardial perfusion on the microvascular…

…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…

…80–85 mmHg in chronic hypertension or when there are signs of inadequate perfusion Urine output 0.5 mL/kg/h Lactate Falling A clearance…

…acute stroke to identify large vessel occlusion, dissection or other vascular pathology CT perfusion Used with an unclear time of onset, a late time window…

…one year risk of major bleeding in patients with atrial fibrillation (AF) who are taking anticoagulants. It was developed in 2010, using data from the…

…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…

…Cessation also improves vascular health and may reduce cardiovascular risk within several years, although risk may remain higher than that of never smokers for a…

…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…

…Give small boluses, for example 250 to 500 mL, with immediate reassessment of the blood pressure, pulse, peripheral perfusion, mental state and chest findings. Avoid

…interaction between these acquired risks and age related cardiovascular remodeling contributes to the high incidence and prevalence of coronary and vascular disease in older adults…

…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…

…30 mmHg) under vascular surgical supervision Diabetes with neuropathy Reduced compression, closer monitoring — the patient cannot feel pressure injury Peripheral neuropathy of other cause As…

…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…