ECG Myocardial ischemia and infarction Use of ECG in acute coronary syndromes & chest pain patients An ECG must be performed on all patients seeking medical…

…to chronic neuropathic pain. This syndrome presents with a dry or minimally productive cough and a tickle or sensitivity in the throat, and is made…

…abdominal pain or a rapid deterioration in general condition may be the only signs of infection. Corticosteroids and other immunosuppressive treatments can blunt the febrile…

…adrenaline and initial fluid treatment Adrenaline infusion and advanced resuscitation in a monitored setting The grade can change within minutes. Treat the current physiological threat…

…per day. Patches have no place in acute, unstable pain: the onset takes 12 to 24 hours and the offset just as long. Breakthrough dose…

…pain is a broad clinical syndrome rather than a narrowly defined symptom. It includes pain, pressure, tightness, heaviness, burning, or discomfort in the chest and…

…titration in acute severe pain Practical points during titration: Give the injection slowly over at least a minute; a rapid injection causes nausea and a…

…therapy and Opioid therapy in severe pain. Cardiac arrest Drug Adult Child : : : Adrenaline 1 mg IV/IO every 3–5 min. In asystole and PEA…

…chest pain itself, encompassing symptoms like tightness, pressure, and discomfort in the chest, arms, neck, jaw, upper back, and abdomen, as well as dyspnea and…

…the chest pain pathway. Testing is optional and may be selected according to clinical judgement. Low to moderate probability: greater than 5% to 50% in…

…symptoms in clinical practice and it is fundamental to be able to differentiate benign from serious etiologies. Therefore, when encountering a patient with chest pain…

…stabilized. This usually takes 2 to 3 days and the patient must not have experienced chest pain during the last 12 hours before exercise. Patients…

…ECG, and normal initial troponin may be observed in a chest pain unit or another non intensive care setting while serial testing is completed. Diagnostic…

…blood pressure increases during exercise. The increase in cardiac output during moderate exercise is the result of increased stroke volume and increased heart rate. However…

…include: sudden symptoms occurring at rest or with minimal exertion; symptoms lasting at least 10 minutes unless treated immediately; severe chest pain, pressure, or discomfort…

…in paracentesis is not performing it. Every patient admitted with ascites should undergo a diagnostic paracentesis , because spontaneous bacterial peritonitis often lacks abdominal pain and…

…s left arm should be placed under the patient's head. This stretches in the chest wall, such that the distances between the ribs increase…

…the corticosteroid and the lidocaine in the same syringe. The anaesthetic confirms that the injection has gone to the right place — immediate pain relief is…

…spot, in three minutes, without drugs . The diagnosis rests on the history, a positive Dix–Hallpike test and the absence of other neurological findings. The…

…Indications Evaluation of chest pain with an intermediate pre test probability of coronary artery disease. Assessment of exercise capacity and symptoms in known heart disease…

…3. An embedded body: the patient is positioned at the slit lamp with the forehead against the band and the chin in the rest. Support…

…Overview Acute coronary syndrome comprises STEMI, NSTEMI and unstable angina. Management begins in parallel with the diagnostic work up. Obtain an interpretable 12 lead ECG…

…or after suturing over a joint. Pain relief and stabilisation for transfer in a suspected fracture. Clinical suspicion of a scaphoid fracture despite a normal…

…confused: replacement therapy in adrenal insufficiency (which must be increased under stress) and pharmacological anti inflammatory treatment (which must be tapered in a controlled fashion…

…abrupt reduction in walking distance before claudication, accompanied by moderate pain or paresthesia, while sensory and motor function remain preserved. The duration and progression of…

…in STEMI, radiate to the neck, shoulders or back. However, acute pericarditis is more likely if inspiration and supine position worsens the chest pain, and…

…in any of the following: A systolic blood pressure < 90 mmHg caused by the arrhythmia. Ongoing myocardial ischaemia with chest pain and ECG changes…

…deeper and more controlled freeze on flat surfaces; spray technique is better on irregular surfaces and in the scalp. Complications Complication Frequency and comment : : Pain…

…principle, not a universal target. Chronic hypertension shifts autoregulation in the brain and kidneys towards higher pressures. Too rapid a normalisation can therefore cause cerebral…

…at the lower border where the neurovascular bundle lies, and the drainage is stopped for coughing, chest pain, or when the volume limit is reached…

…used in units with airway expertise. Procedure 1. Dry the skin and shave where necessary. Do not clip the hair — small cuts cause burning pain…

…Pain relief. Delivery IV, IM, PO, transdermal Dose Injection IV: • 150 μg in 1 ml vial. Dilute with 10 ml of normal saline and…

…perfusion abnormalities and ultimately leading to chest pain (angina). Myocardial perfusion imaging techniques, such as SPECT and PET, can detect perfusion abnormalities early in this…

…arterial disease and at the same time indicates a substantially increased risk of myocardial infarction and stroke. Indications Intermittent claudication, rest pain in the foot…

…the myocardium, thereby intensifying chest pain. In contrast, NSTEMI and UA typically involve partial occlusions, resulting in subendocardial ischemia and comparatively milder symptoms. For the…

…bridging; myocardial metabolic abnormalities; and abnormal pain perception in patients without demonstrable ischaemia. The absence of obstructive disease therefore does not establish a benign diagnosis…

…fasciitis — pain that is disproportionately severe, a rapid course, skin discolouration, systemic upset — is an acute surgical emergency, not an abscess. Preparation and equipment No…

…after trauma. A symptomatic effusion causing pain or restricted movement (therapeutic aspiration). Intra articular corticosteroid injection in verified inflammatory or osteoarthritis related joint disease. Contraindications…

…ongoing compression therapy, and always in the event of new or increasing pain. Preparation and equipment Doppler for the ankle brachial index, blood pressure cuff…

…a hollow beneath the acromion, the arm is held in slight abduction and external rotation, and the patient resists internal rotation. Check the axillary nerve…

…infarction primarily in the context of suspected acute coronary syndrome and acute myocardial ischaemia. Patients may present with acute chest pain or chest pain equivalent…

…greater in patients with diabetes mellitus and increases with age. STEMI may present as sudden onset breathlessness. Other less common presentations, with or without pain…

Cardiology Pharmacology & dosing Definition and pathophysiology Statins inhibit 3 hydroxy 3 methylglutaryl coenzyme A reductase, the rate limiting enzyme in cholesterol synthesis. Reduced hepatic cholesterol…

…categorised as myocardial injury. Clinical Presentation and Symptoms Patients with Type 2 MI frequently present with acute chest pain and troponin elevation. The clinical manifestation…

…of standing to determine if orthostatic hypotension is present. High risk features on history include: New onset of chest discomfort, abdominal pain, shortness of breath…

…depending on the size of the thrombus and the plaque. The patient will experience severe chest pain due to the abrupt reduction of coronary blood…

…has traditionally been defined and managed as a distinct clinical entity. The hallmark of stable coronary artery disease is exercise related angina pectoris (chest pain)…

…pathological Q waves may be used to diagnose myocardial ischemia and infarction. Symptoms – Patients with acute myocardial infarction may present with typical ischemic chest pain…

…in diagnosing ischemia and infarction and guide appropriate management strategies. For instance, administering nitroglycerin to alleviate ischemic chest pain may lead to hemodynamic collapse in…

…QRS complex and the P wave is positive in lead II. Sinus tachycardia is always considered pathological and the underlying cause must be investigated. Pain…

…has traditionally been defined and managed as a distinct clinical entity. The hallmark of stable coronary artery disease is exercise related angina pectoris (chest pain)…

…are women) and elderly individuals. Clinical characteristics and ECG changes in takotsubo cardiomyopathy The typical patient presents with severe chest pain, dyspnea and occasionally hemodynamic…

…Expansion may produce pain in the abdomen, chest, lower back or scrotum. Aneurysmal pain is clinically important because it may herald rupture and constitutes a…

…common in NSTEMI and unstable angina (please refer to Approach to Patients with Chest Pain). As in patients with STEMI, those with NSTEMI and unstable…

…cannula. 4. Measure the blood pressure in both arms at the first assessment, particularly in chest pain, back pain or suspected acute aortic syndrome. 5…

…about: Onset and time course. Increased dyspnoea compared with usual. Increased sputum volume and new sputum purulence. Fever, rigors and respiratory tract symptoms. Chest pain…

…membranes in pregnancy — a speculum may be used, but not digital examination until the position of the placenta is known. Recent gynaecological surgery. Preparation and…

…discharge, dizziness, tinnitus, fever in a child without an obvious focus, and before every ear syringing. Removal of cerumen: Hearing loss, a blocked sensation, itching…

…acute myocardial infarction and at least one of the following criteria present: haemodynamic instability or cardiogenic shock recurrent or ongoing chest pain refractory to medical…

…lasting at least 10 minutes unless treated immediately, severe chest pain or pressure, and an accelerating pattern. An accelerating pattern includes increasingly frequent or severe…