…oesophagus or upper gastrointestinal tract, ileus and ongoing upper gastrointestinal bleeding. Marked agitation or inability to cooperate. Copious secretions without an effective cough. Choice of…

…than non variceal bleeding [1,2]. Upper gastrointestinal bleeding can present as haematemesis, coffee ground vomiting or melaena. Haematochezia can occur in massive upper bleeding…

…unless contraindicated Head of the bed 30–45° Stress ulcer prophylaxis During mechanical ventilation, in coagulopathy, or with a history of gastrointestinal bleeding Refeeding syndrome…

…Severe coronary artery or structural heart disease High risk features on examination include: Unexplained systolic blood pressure < 90 mmHg Suggestion of gastrointestinal hemorrhage Persistent…

…and subsequent sudden death are rare, the arrhythmia is precipitated by an extensive list of "torsadegenic" or "QT liability" drugs. This includes Class III antiarrhythmic…

…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…

…recorded ECG) is a very strong predictor of survival. This is because cardiac arrest presenting with ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT) can…

…is 12 h, a primary PCI strategy is indicated in the presence of ongoing ischemic symptoms, haemodynamic instability, or life threatening arrhythmias. I C A…

…with congenital heart disease. Initiation Strategies Because of its ability to significantly prolong the QT interval and cause torsades de pointes or provoke severe bra

…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…

…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…

…compromise or skin tenting — reduce promptly, before radiography. The longer a joint remains dislocated, the harder the reduction becomes and the greater the risk of…

…or electrophysiology in relation to ACE inhibitor therapy. Biomarkers and Laboratory Findings Monitoring renal function and potassium is a critical component of ACE inhibitor therapy…

…pacing may rarely result in pacing during ventricular repolarization and provoke ventricular tachycardia or ventricular fibrillation. The likelihood of clinically significant EMI is generally low…

…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

…days as necessary. Supplemental infusions of 150 mg over 10 minutes can be utilized for breakthrough ventricular tachycardia (VT) or ventricular fibrillation (VF). IV infusions…

…disappearance of Korotkoff sounds; if sounds persist, the fourth Korotkoff sound is used. Office blood pressure: blood pressure measured in a clinical setting, manually or…

…inversion of the T waves. These T waves are called post ischemic T waves and they indicate that the infarction process is more or less…

…low risk of pneumothorax Uncomfortable for an awake patient, harder to keep the dressing clean with a tracheostomy or copious secretions Subclavian vein Most comfortable…

…A score of 3 or more indicates a difficult intubation — call for help and get out the videolaryngoscope and plan B before you give the…

…or hyperkalaemic ECG changes at any level Immediate emergency treatment, continuous ECG monitoring and early assessment of the need for dialysis ECG changes or serious…

…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…

CPR Cardiac arrest is a result of tachyarrhythmia, bradyarrhythmia or asystole. The tachyarrhythmias include ventricular fibrillation (VF) and pulseless ventricular tachycardia (VT). The bradyarrhythmias include…

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

…and where no liver, lung or vessel lies in the path of the needle. Access Puncture site Direction Comment : : : : Subxiphoid 1–2 cm below and…

…vomiting and secretions. Suction and give oxygen as needed. Intubate for a threatened airway, a marked risk of aspiration, or failure that is not rapidly…

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

…Phase 0 : Indicates the beginning of the next inspiration. Normal ETCO 2 : 38 mmHg (5 kPa) or 5%. Monitoring ETCO 2 aids in: Assessing ventilation…

…characterized by systemic congestion resulting from impaired RV filling and/or reduced RV output. Recognition of this syndrome is critical because it may precede haemodynamic…

…preferably before or at the same time as carbohydrate administration. 3. Rapid identification of seizures, delirium tremens, infection, trauma and metabolic disturbance. 4. Monitoring at…

…a distinct class of inodilator. It enhances myocardial contractility and induces peripheral vasodilation through cardiac myofilament calcium sensitisation. This process is achieved via calcium dependent…

…aphasia, hemianopia or hand paresis in a person of working age Blood pressure Measure initially in both arms if this does not delay reperfusion treatment…

…maximum score of 9. The score takes into account various risk factors that contribute to bleeding risk, including uncontrolled hypertension, impaired renal or liver function…

…of myocardium at risk. Over 48 hours: urgent PCI is still indicated with continuing ischaemia, shock, serious arrhythmia or acute heart failure. Routine opening of…

…environmental exposures are associated with continued or resumed smoking after the acute event and warrant particular attention. Cardiovascular benefits of cessation The principal benefits relevant…

…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…

…or dialysis DOACs are not recommended. Warfarin after individual assessment Rule of thumb for the monitoring interval: eGFR divided by 10 gives the number of…

…indication and contraindications, attach ECG monitoring and insert a venous cannula. 2. Document the baseline status of the chosen finding — measurement, photograph or video. 3…

…can swallow safely. 4. Give intravenous glucose if the patient has a reduced level of consciousness, is having seizures or cannot swallow. 5. If there…

…why, or the patient at risk of carbon dioxide retention is given 15 litres on a reservoir mask and drifts off into a respiratory acidosis…

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

…and quality of life may be equally important therapeutic objectives. Evidence from randomized trials is often less applicable to very frail or multimorbid patients because…

…of both thromboembolic and hemorrhagic risks. The diagnostic prerequisite for clinical AF remains the documentation of the arrhythmia via a standard 12 lead ECG or…

…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…

…be confused with a venous access. Indications Continuous blood pressure monitoring in haemodynamic instability or during ongoing vasoactive treatment. Conditions in which blood pressure must…

…region. The time limit is not a guarantee. Where the stroke risk is high or the time of onset uncertain, choose the more cautious course…

…Basic principles of treatment The patient should be managed in an emergency department, an intensive care unit, a coronary care unit or another setting that…

…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…

…may be falsely normal because of medial sclerosis — in that case add toe pressure measurement. Absolute: ABI < 0.5 or toe pressure < 30…

…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…

…lactate, two sets of blood cultures, and a culture from the likely focus 0 to 15 min Ringer's acetate for hypotension or hypoperfusion, usually…

…to try yet another dose. Chronotropic support is given as an infusion of isoprenaline, adrenaline or dopamine according to local practice, and does not replace…

…nature of HCM. By combining these factors, the calculator generates a 5 year SCD risk percentage , which helps clinicians stratify patients into low, intermediate, or…

…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…

…the volume of blood the heart pumps and the resistance encountered in the systemic circulation. Therefore, alterations in heart rate, stroke volume, or vascular tone…

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

…blood pressure monitoring or ambulatory blood pressure monitoring. Other guideline formulations similarly define resistant hypertension as blood pressure above goal despite three or more antihypertensive…

…setting of acute coronary syndrome, AF is the most frequent supraventricular arrhythmia. It may predate the coronary event, be detected for the first time, or…

…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…

…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…