…right atrial pressure. Levosimendan represents a distinct class of inodilator. It enhances myocardial contractility and induces peripheral vasodilation through cardiac myofilament calcium sensitisation. This process…

…evidence of systemic venous congestion Blood pressure and evidence of hypotension Clinical evidence of low cardiac output or shock RVI may produce severe venous congestion…

…smoking and anticipated barriers to cessation. Exposure to second hand smoke. Use of cannabis, electronic cigarettes or other inhaled products. Readiness to attempt cessation. Depression…

…needed. Intubate for a threatened airway, a marked risk of aspiration, or failure that is not rapidly reversed by an antidote B Respiratory rate, saturation…

…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

…gaze palsy — that can be assessed before and during the window of effect. The muscarinic effect may at the same time produce marked bradycardia and…

…careful monitoring, and shared decision making. Definition and Pathophysiology Aging related cardiovascular vulnerability Normal aging produces structural and functional cardiovascular changes that increase susceptibility to…

…is myocardial ischaemia caused by transient abnormal vasoconstriction of one or more coronary arteries. Epicardial spasm produces a reversible functional occlusion and usually causes transmural…

…equipment used during surgery, particularly electrosurgery. EMI may produce inappropriate sensing, activation of rate responsive functions, device resetting, inhibition of pacing, inappropriate ICD therapy, or…

…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…

…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…

…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…

…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…

…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…

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…

…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

…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…

…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…

…discussed previously in this article. Briefly, accelerated ventricular rhythm (also called idioventricular rhythm) is a benign ventricular rhythm with a heart rate of 60–10

…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…

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…

…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…

…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…

…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…

…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…

…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…

…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…

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

…on: Blood pressure and evidence of hypotension Heart rate and tachycardia Respiratory rate and oxygenation Evidence of systemic congestion or acute RV failure Syncope or…

…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…

…does the work of ventilation — raising IPAP and EPAP by the same amount does not increase ventilation at all . The backup rate is usually set…

…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…

…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…

…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…

…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…

…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…

…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…

…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…

…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…

…Condition Overall strategy Common first choices : : : Acute aortic syndrome Immediate rate control and rapid reduction of the systolic blood pressure towards 100 to 120 mmHg…

…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…

…disorientation, agitation, drowsiness or a reduced GCS Respiration A respiratory rate of at least 22/min, increased work of breathing, a new oxygen requirement, a…

…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…

…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…

…Tachycardia Increased ventricular rate in AF Ventricular arrhythmias Cardiac ischemia Hypertension (in patients on nonselective β blocker) Tolerance after a few days Norepinephrine Shock (any…

…in heart rate, stroke volume, or vascular tone can significantly impact MAP, reflecting the dynamic interplay between cardiac function and vascular resistance. Advantages of measuring…

…diuretic appropriate for kidney function. In patients with an estimated glomerular filtration rate below 30 mL/min/1.73 m², an adequately up titrated loop…

…management of ventricular rate. However, AF causing acute haemodynamic instability requires prompt treatment, with electrical cardioversion preferred. Evaluation and risk assessment The evaluation of a…

…criteria for evaluating the success of TdP treatment or detailed step by step algorithms for alternative therapies when initial pharmacological approaches fail to suppress the…

…Tachycardia Increased ventricular rate in AF Ventricular arrhythmias Cardiac ischemia Hypertension (in patients on nonselective β blocker) Tolerance after a few days Norepinephrine Shock (any…

…Criterion Points : : Clinical signs of deep vein thrombosis 3 Pulmonary embolism is the most likely diagnosis 3 Heart rate 100/min 1.5 Immobilisation ≥ 3…