…the Framingham Heart Study, this linear correction formula adjusts the QT interval based on heart rate without involving square or cube roots. It has been…

…and most serious dosing errors arise at the dilution step, not in the choice of dose. Paediatric doses are calculated on actual body weight unless…

…who declines blood transfusion. The decision must be documented and alternatives (iron, tranexamic acid, cell salvage, haemorrhage control) planned in advance. A history of a…

CPR This chapter will introduce the most common and essential terms used in resuscitation science, providing a foundation for understanding subsequent chapters. SCA (Sudden Cardiac…

…and dynamic hyperinflation. The consequences are increased work of breathing, exhaustion and, in the most severe cases, hypotension, pneumothorax and respiratory arrest [1]. The first…

…appearance of the flutter waves will depend on the location and direction of the re entry circuit. In the most common type of atrial flutter…

…depends on line density, which decreases with increasing distance from the transducer. Frame rate The two dimensional image must be updated rapidly and continuously in…

…saline for flushing. An intraosseous drill system with needles in three lengths: short for children and slim limbs, medium for most adults, long for thick…

…thresholds. Clinical Presentation and Symptoms Most AAAs are asymptomatic and are identified either during routine abdominal examination or incidentally on imaging performed for another indication…

…flutter waves on the ECG that do not suggest a typical circuit. A diagnostic pitfall arises because typical circuits occurring in diseased atria—most frequently…

…ventricular rate slower than 50 beats per minute. P waves with constant morphology preceding every QRS complex. P wave is positive in limb lead II…

…rate exceeds 100 beats per minute. Although sinus tachycardia is the most common tachyarrhythmia, it may not always be straightforward to diagnose on the ECG…

…the mainstay of this therapy). Rate control does not affect the rhythm per se . Rhythm control, on the other hand, attempts to restore sinus rhythm…

…heart disease and GUCH Complex malformations often require intervention (surgical or catheter based intervention). In addition to the malformation, these subjects frequently develop associated complications…

…tachycardia (EAT) most commonly occurs in individuals with underlying structural or electrical heart disease. Less frequently, it may also present in individuals without identifiable cardiac…

…protocol depends mainly on local traditions. The treadmill and cycle ergometer (bicycle) are the most frequently used test methods. Cycle ergometer is preferred in Europe…

Arrhythmias and arrhythmology ECG Mechanisms of cardiac arrhythmias: from automaticity to re entry This section introduces the most common arrhythmias encountered in clinical practice, beginning…

…heart rate 50–100 beats per minute; (2) P wave precedes every QRS complex; (3) the P wave is positive in lead II and (4…

…per guidelines. Most patients require an immediate intravenous dose of 1 mg epinephrine . For anaphylaxis without cardiac arrest: Administer 0.5 mg epinephrine intramuscularly in…

…hyperkalemia and hypokalemia can induce life threatening arrhythmias and cardiac arrest, with hyperkalemia being the most prevalent electrolyte disturbance observed in cardiac arrest scenarios. Hypocalcemia…

…Cardiac troponin levels are extremely low in healthy subjects; the 99 th percentile is less than a few nanograms per liter of blood (typically <5…

…escape rhythm on the ECG. Indeed, the surface ECG frequency cannot differentiate escape rhythms originating near the atrioventricular node from those originating in the bundle…

…possess automaticity and thus pacemaker function. The intrinsic rate of depolarization in these cells is 60 beats per minute. The resulting P wave is morphologically…

…there are fundamental gaps in knowledge, with some of the most critical components of current guidelines being based on observational data ( e.g compression rate…

…volume overload is the most common cause. Ebstein's anomaly The prevalence of Ebstein's anomaly is approximately 1 case per 200.000 live births…

…100–250 beats per minute) and cardiac output is affected (i.e reduced) in virtually all cases. Ventricular tachycardia causes immense strain on the ventricular…

…revolutions per minute, kept steady. 3. ECG continuously , with a printout every minute and on symptoms. 4. Blood pressure every second minute and on symptoms…

…3 Pulmonary embolism is the most likely diagnosis 3 Heart rate 100/min 1.5 Immobilisation ≥ 3 days or surgery in the last 4 weeks…

…Table 2. Reference values for the most important parameters (Rijnbeek et al) Numbers are medians with 2 nd and 98 th percentile in parenthesis. These…

…infarction (MI), antianginal drugs have not been shown to improve long term cardiovascular outcomes in CCS. General strategy For most patients, initial therapy consists of…

…regular (as is the atrial) with a rate ranging between 150 and 250 beats per minute. The P wave is not visible in most cases…

…40 in endemic regions [3] . The global prevalence is estimated at 1 to 5 per 10,000 individuals, though this figure rises dramatically in Southeast…

…interchangeably both in clinical practice and in the literature. Tachyarrhythmias: causes, differential diagnoses, treatment and management Any heart rate faster than 100 beats per minute…

…heart rate 50–100 beats per minute; (2) P wave precedes every QRS complex; (3) the P wave is positive in lead II and (4…

…leadless pacemaker being the most promising improvement. 1 Given the wide use of pacemakers and the trend towards increased use of cardiac devices in general…

…The most widely adopted parameter is the ejection fraction (EF). The concept of ejection fraction was introduced by Braunwald and colleagues in 1962 ( Braunwald et…

…Table 2. Reference values for the most important parameters (Rijnbeek et al) Numbers are medians with 2 nd and 98 th percentile in parenthesis. These…

…per cm above 152 cm. Adjusted body weight: ideal weight + 0.4 × (actual weight − ideal weight). Used for aminoglycosides and when estimating creatinine clearance in…

…In most hypertensive emergencies the following is aimed for: 1. Lower the mean arterial pressure by no more than about 20 to 25 per cent…

…a new oxygen requirement, a saturation below 93 per cent on air, or a falling PaO2 Circulation A systolic blood pressure of 100 mmHg or…

…2%–0.5% per year beyond the first year, although the available material does not establish a significant increase in late morbidity or mortality attributable…

…is only one of the parameters that must be evaluated and the final result of the test depends on an integrated assessment of six components…

…For example, Bazett's formula is only suitable in adults with a heart rate between 60 and 90 beats per minute. Bazett's formula over…

…of bradyarrhythmia on ECG recordings. Normal heart rate and normal variants Normal resting heart rate is 50 to 95 beats per minute in the afternoon…

…thus pumping) activity at all, an escape rhythm must arise in an ectopic focus (located distal to the block). Third degree AV block is a…

…beats per minute. As in ventricular rhythm the QRS complex is wide with discordant ST T segment and the rhythm is regular (in most cases…

…beats per minute (bpm), which terminates spontaneously within 30 seconds [1] . While often asymptomatic, NSVT serves as a critical marker of arrhythmogenic risk, particularly in…

…mg Oral bioavailability about 35 per cent Paracetamol PO or IV 1 g × 4 The basic analgesic; always give it in parallel unless contraindicated NSAID…

…antibiotics on the basis of sputum purulence, the other cardinal symptoms and the severity of the illness. 7. Start NIV without undue delay in persistent…

…the margin must be included in the freeze. Contraindications Absolute: Suspected melanoma or any other pigmented lesion of uncertain diagnosis. A lesion in which histology…

…events per 1000 treated patients. Aspirin for long term secondary prevention Standard role Aspirin remains the traditional antiplatelet agent for long term secondary prevention in…

…ischemia, seen in multivessel disease, exists when all coronary arteries are equally compromised, leading to uniform perfusion that may appear deceptively normal on SPECT. Detecting…

…a few centimetres beyond the planned ends of the cast. 3. Pad evenly , 2–3 layers with about 50 per cent overlap, and add extra…

…depending on the clinical picture Moderate 6.0 to 6.4 mmol/L ECG and cardiac monitoring. Emergency treatment is often warranted, particularly in an…

…not to normalise the plasma sodium. Chronic or minimally symptomatic hyponatraemia must be corrected in a controlled fashion, since too rapid a rise can cause…

…in older protocols but is no longer routinely recommended — alkaline urine increases the precipitation of calcium phosphate. Contraindications Hypokalaemia — must be corrected first or in…

…essential to reconfirm the rhythm in two leads if possible to distinguish true bradyarrhythmic or asystolic arrest from other tachyarrhythmic events. On the surface electrocardiogram…

…s theorem (Harry Nyquist), which demonstrates that a wave must be sampled ( i.e recorded) at least twice per cycle in order to be rel

…an applanation tonometer on the slit lamp, or a hand held device (iCare, Tono Pen). Procedure Systematic examination 1. Visual acuity in each eye separately …

…Several actions must be executed systematically and rapidly. These actions constitute the chain of survival ( Figure 1 ). The chain of survival in out of hospital…