…older the patient and the more significant the heart disease, the more likely ventricular tachycardia. The Brugada group has also developed an algorithm to differentiate…

…intervals for QTc duration according to Bazett's formula. Note that a QTc interval 480 is always considered pathological. For patients with bundle branch blocks…

…septum and stop with correctly performed compression. The reason compression nevertheless so often fails is that it is done wrongly: the patient pinches the nasal…

…the suspected focus, but avoid sampling that delays antibiotics 6 Take a targeted history and examine the patient, with particular attention to the mouth, throat…

…corrected with iron, B12 or folate in a stable patient. Transfusion given solely to reach a laboratory value without a clinical question. A patient who…

…patient have severe neurological symptoms that may be due to the hyponatraemia? 2. Is the hyponatraemia acute or chronic? Severe symptoms require immediate treatment with…

…findings are absent in roughly half of patients with a central cause. A normal routine neurological examination is therefore not sufficient to exclude stroke [3]…

…reason to refrain from investigating postmenopausal bleeding or a visible cervical lesion. Contraindications There are no absolute contraindications, but refrain or adapt in: The patient…

…mechanisms may coexist, diagnosis and classification must integrate haemodynamics with the patient’s clinical context and the results of all relevant investigations. Haemodynamic definition At…

…not an automatic response to chest pain. It is appropriate when the expected information is likely to change management. In patients with a very low…

…94 to 98 percent An individually documented target prescription, for example in chronic hypercapnia Follow the patient's prescription, if it is clinically reasonable Give…

…eyelid. Ask the patient to look down. Grasp the eyelashes, press gently downwards on the upper border of the tarsal plate with a cotton bud…

…donor care The time from withdrawal of treatment to circulatory arrest Indications An intensive care patient with severe brain injury in whom total brain infarction…

…the test to be interpretable. Procedure 1. Schedule the test in the morning, preferably starting between 08:00 and 09:00 , with the patient fasting…

…those who did, only a minority had a reduced value — the majority of sudden cardiac deaths occur in patients with preserved LVEF, for whom no…

…to the superior vena cava, compressible if bleeding occurs, low risk of pneumothorax Uncomfortable for an awake patient, harder to keep the dressing clean with…

…with proximal weakness Red flags and pitfalls Stopping a corticosteroid abruptly after longer term treatment. Not giving a stress dose to a patient with adrenal…

…should therefore be checked with a capillary or venous measurement [5]. Treatment The awake patient who can swallow safely Give 15 to 20 g of…

…or previously athletic patients. Beta blockade, a pacemaker and autonomic neuropathy can at the same time mask the expected tachycardia. Aids to assessment The shock…

…The nasal cannula, the simple mask and the reservoir mask deliver an FiO2 that varies with the patient's minute ventilation: a markedly hyperventilating pati

…may indicate underlying arrhythmias. Age : Younger patients are generally at higher risk of SCD due to the progressive nature of HCM. By combining these factors…

…changes), renal function, and potassium should be evaluated within 1 to 2 weeks after initiation of ACE inhibitors, especially in patients with preexisting azotemia, hypotension…

…that CRT patients may rely on continuous biventricular pacing for haemodynamic stability. In patients with resynchronization devices, maintaining CRT during surgery is recommended to provide…

…trials have shown muscle adverse event rates similar to those with placebo, whereas approximately 10% of patients in registries and routine clinical practice report muscle…

…to the left atrial appendage, although competing mechanisms such as large artery atherosclerosis and small vessel disease may also contribute to stroke in patients with…

…Thus, cardiac index is cardiac output normalized to body surface area. The ultrasound system calculates body surface area using the patient's sex, weight and…

…and settings, which can be tailored to the patient's needs. Programming is done through an external device that communicates wirelessly with the pacemaker. A…

…Arrest Patients). Please refer to HOPE Score. Severity Features Body temperature (°C) Mild hypothermia Conscious with tremors 32 35°C Moderate hypothermia Impaired consciousness, with or…

…from dyspnea which is shortness of breath. Dyspnea may be due to poor exercise capacity (with normal ventilatory capacity and cardiac output), diminished ventilatory capacity…

…in Figure 1. The ultrasound system automatically calculates RWT (Relative Weight Thickness), provided that the patient's weight, height and sex are entered. RWT is…

…are obtained with the patient positioned in the left lateral decubitus position. In this position, the heart comes closer to the thoracic wall, with less…

… the patient cooperates Intra articular local anaesthesia Lidocaine into the glenohumeral joint in shoulder dislocation, with an effect equivalent to sedation and fewer adverse effects…

…GY. A novel user friendly score (HAS BLED) to assess 1 year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey…

…Association (NYHA) classification. The source material specifically frames many pharmacological recommendations for patients with symptomatic NYHA class II–IV HFrEF. Advanced or refractory heart failure…

…the patient. Multiple potentially high risk plaques may exist throughout the coronary tree, while inflammation and thrombotic susceptibility are often systemic rather than confined to…

…waves) in a patient with early repolarization. Figure 4. Osborn wave (J wave) in a patient with early repolarization. This patient was 31 years old…

…than the load could reasonably explain). The probability of hypertrophic cardiomyopathy is inversely related to age, such that the younger the patient presenting with hypertrophy…

…ventricle. Studies from the US and Japan has estimated that up to 2% of patients referred to PCI with a suspicion of STE ACS/STEMI…

…test; performed on the wrong patient or by an inexperienced examiner it is unreliable. A single central feature is enough to proceed with urgent investigation …

…in the mouth. Nose 1. Ask the patient to blow the nose gently. Clear mucus with suction without pushing the object backwards. 2. Apply the…

…after a few minutes' rest, if the patient's condition allows. 7. With titratable intravenous treatment and an unstable course, an arterial line should be…

…plastic film or a dressing to protect an ulcer, and where needed a photoplethysmograph and a toe cuff. Preparation: The patient must have rested lying…

…severe metabolic derangement. Major surgery with expected blood loss or large volume shifts. Patients in whom non invasive measurement is unreliable: marked obesity, pronounced vasoconstriction…

…a pulse pressure variation 13% in a ventilated patient in sinus rhythm without spontaneous breathing, passive leg raising with an increase in stroke volume 10%…

…hypopigmentation. Areas with poor circulation, above all the lower leg in a patient with peripheral arterial disease or diabetes — the wound may not heal. Over…

…Wait 10 minutes — insufficient waiting time is the commonest reason for the patient finding the procedure painful. Test with a needle tip before you start…

…Monitoring with ECG, blood pressure and saturation throughout the investigation. Explain to the patient what is going to happen and that the most important thing…

…procedure is the wrong treatment : Aortic dissection with haemopericardium — drainage can increase the bleeding and worsen the prognosis. The patient must go to cardiothoracic surgery…

…TIA, systemic thromboembolism) in the next 12 months and the calculations apply to untreated patients with non valvular atrial fibrillation ( Table 1 ). CHADS VASc Score…

…uniform across the HFmrEF population. Some patients have a pathophysiological profile closer to HFrEF, whereas others have features overlapping with HFpEF, including abnormalities of LV…

…patients with LBBB and a left ventricular ejection fraction (LVEF) $< 35%$, the implantation of a defibrillator or a CRT D is indicated to…

…is an important clinical clue. Haemodynamic severity The presentation may range from mild right ventricular impairment to cardiogenic shock. Patients with hypotension, marked low output…

…is managed according to the standard CPR algorithm, except that interventions to reoxygenate the patient is of paramount importance. In cardiac arrest due to asphyxia…

…amiodarone, or adrenaline (epinephrine). In the event of a cardiac arrest in a pregnant patient, immediate consultation with an obstetrician, neonatologist, and anesthesiologist is essential…

…Coimbra R. Open chest versus closed chest cardiopulmonary resuscitation in trauma patients with signs of life upon hospital arrival: a retrospective multicenter study. Crit Care…

…with the intent to perform PCI. The decision to transfer the patient to the ICU or CCU depends on the system of care and patient…

…acute coronary syndromes & chest pain patients An ECG must be performed on all patients seeking medical attention due to chest discomfort or other symptoms that…

…For the same reason, R wave peak time may also be prolonged. This prolongation may also be due to myocardial fibrosis which is typical in…

…intervals for QTc duration according to Bazett's formula. Note that a QTc interval 480 is always considered pathological. For patients with bundle branch blocks…

…of these patients have a new bundle branch block, which in the case of left bundle branch block should lead the clinician to activate the…