…increase the entry of salicylate into the central nervous system. Discuss the case early with the poison control centre and with anaesthesia or intensive care…

…at the same time reduces the passage of salicylate into the central nervous system. Contact your national or regional poison control centre for advice on…

…patients with left ventricular dysfunction, though those with depressed ejection fraction should receive it with great caution due to the risk of hypotension. Peripheral IV

…itself an indication for emergency insertion in an unstable situation: intraosseous access or a large bore peripheral cannula bridges the gap until conditions are controlled…

…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…

…coronary syndrome Reinfarction reduced by approximately 30–40%; death reduced by approximately 35–45% Peripheral artery disease Lower risk of progression to chronic limb threat

…slow or has stopped. The first steps Step Content : : 1 ABCDE. Assess the level of consciousness, the airway, the work of breathing, the peripheral perfusion…

…of fluid management. Contraindications Infection, burn or trauma over the insertion site. Insufficient collateral circulation to the hand. Vascular disease in the limb: marked peripheral…

…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…

…continuous monitoring, activate the sepsis pathway according to local practice, oxygen if hypoxaemic, two large bore peripheral cannulae 0 to 10 min A blood gas…

…disease, and peripheral arterial disease. More than 70% of older adults presenting with myocardial infarction, stroke, acute aortic syndromes, or heart failure have preexisting hypertension…

…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…

…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…

…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…

…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…

…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…

…to initial rhythm If the initial rhythm is VF or VT, survival is 30% in OHCA. If the initial rhythm is PEA (pulseless electrical activity)…

…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…

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…

…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…

…a few seconds of myocardial electrical activity and there is a chance that ischemic episodes are missed. Indeed, studies (with continuous ST segment monitoring) show…

…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…

…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…

…of tachyarrhythmia, bradyarrhythmia or asystole. The tachyarrhythmias include ventricular fibrillation (VF) and pulseless ventricular tachycardia (VT). The bradyarrhythmias include all bradyarrhythmias, pulse less electrical activity…

…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 …

…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…

…glutamate signalling, in part via NMDA receptors. With prolonged alcohol exposure the nervous system adapts through reduced GABA mediated inhibition and increased glutamatergic activity. When…

…MAP ≥ 65 mmHg 80–85 mmHg in chronic hypertension or when there are signs of inadequate perfusion Urine output 0.5 mL/kg/h Lactate…

…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…

…electrical instability or a large area of myocardium at risk. Over 48 hours: urgent PCI is still indicated with continuing ischaemia, shock, serious arrhythmia or…

…the unit. Preparation and equipment A device capable of both CPAP and bilevel ventilation, or alternatively flow generated CPAP with a PEEP valve. Masks in…

…possible or known plaques, or stenosis. Diagnostics Electrocardiogram and Cardiac Monitoring An ECG should be performed if there is suspicion of syncope due to an…

…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…

…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…

…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…

…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…

…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…

…only monitoring and preparedness. Asystole with no electrical activity at all — pacing has no documented benefit there. Transcutaneous pacing: burns or wounds in the area…

…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…

…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…

…electrical cardioversion preferred. Evaluation and risk assessment The evaluation of a patient with AF who may require anticoagulation should establish: Whether AF is clinical or…

…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…

…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…

…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…