…is important to be able to differentiate these entities. The older the patient and the more significant the heart disease, the more likely ventricular tachycardia…

…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…

…the patient first. Marked septal deviation towards the bleeding side (relative). Preparation and equipment Personal protective equipment (gloves, a visor, an apron), suction with a…

…A neutropenic patient with a suspected infection and organ dysfunction must therefore be managed as neutropenic sepsis even if the temperature criterion is not met…

…mm (green) for rapid transfusion, preferably two lines in a bleeding patient. A transfusion set with a filter. Blood components must not be given through…

…how acute the condition is. A patient with a chronic plasma sodium of 112 mmol/L may be relatively unaffected, while a rapid fall from…

…most important dangerous differential diagnosis. Clear focal neurological findings are absent in roughly half of patients with a central cause. A normal routine neurological examination…

…examination must be preceded by information about each step, take place with the patient's ongoing consent, and be able to be stopped at any…

…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…

…typicality of symptoms. These newer models improve identification of patients with very low likelihood of obstructive CAD and may reduce unnecessary diagnostic testing. Coronary artery…

…the same time, exacerbation is a clinical syndromic diagnosis, not a sufficient explanation for all acute dyspnoea in a patient with COPD. Pneumonia, heart failure…

…1. Visual acuity in each eye separately , with the patient's usual glasses and then through a pinhole. This is done before any drops. 2…

…DCD: patients in whom death must be confirmed after a 20 minute no touch period, for example after poisoning, since this is not compatible with…

…with the patient fasting or having had a light breakfast according to local practice. Let the patient rest lying down or sitting for at least…

…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…

…give information and obtain consent if the patient is awake, and scan the vessel with ultrasound before you drape — a thrombosed or non compressible vein…

…life produces more marked suppression. Stress dosing in known adrenal insufficiency A patient with primary adrenal insufficiency (Addison's disease), secondary adrenal insufficiency or long…

…until the patient has recovered. 7. Follow up with a meal or with continued glucose administration adapted to the cause. 8. Identify drugs, renal failure…

…been achieved. Penetrating torso injury with shock. A positive FAST scan in an unstable trauma patient. An unstable pelvic fracture with circulatory compromise. A ruptured…

…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

…ICD) is warranted. The HCM Risk SCD calculator is validated to estimate the 5 year risk of SCD in patients with HCM. What is the…

…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…

…interrogation and reprogramming are warranted in higher risk circumstances, particularly for pacing dependent patients, patients with CRT, and ICD recipients undergoing procedures likely to generate…

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

…predictors of ischaemic stroke and systemic embolism are previous stroke or TIA and mitral stenosis. In patients with AF and previous ischaemic stroke treated wi

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

…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…

…detail. Symptom during exercise stress testing Perceived exertion The patient's perceived exertion is a way of estimating the intensity of the physical activity. It…

…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…

…some pressure when holding the transducer against the skin. Patients with extensive subcutaneous fat require harder pressure. Orientation index marker All ultrasound transducers have an…

…miss a posterior dislocation. The exceptions are an obvious recurrent dislocation in a patient with known instability and a low energy mechanism, and a neurovascularly…

…HEMORR₂HAGES bleeding risk score is a clinical tool developed to assess the risk of major bleeding in patients with atrial fibrillation (AF) on anticoagulation therapy…

…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…

…with rupture, fewer than 5% of such lesions caused a clinical event during 3.4 years of follow up in a prospective study of patients…

…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…

…The probability of hypertrophic cardiomyopathy is inversely related to age, such that the younger the patient presenting with hypertrophy, the more likely a genetic etiology…

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

…3. Support the head and lay the patient quickly into the supine position with the head extended approximately 20–30° below the horizontal, maintaining the…

…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…

…with intravenous drugs. Restart or optimise oral treatment and ensure follow up. Rapid lowering can worsen cerebral, coronary and renal perfusion, particularly in patients with…

…or measure at the toe instead. Marked pain that prevents the patient from tolerating compression. Preparation and equipment Equipment: a handheld Doppler probe 5–10…

…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…

…parallel with the palate and straight backwards , not upwards towards the bridge of the nose. 7. When the tip reaches the pharynx: let the patient…

…the prognosis. The patient must go to cardiothoracic surgery. In profound shock, very limited decompression may be considered in consultation with a cardiothoracic surgeon. Myocardial…

…9 As above. Very high Oral anticoagulation (warfarin or NOAC) is recommended for all female patients with a score of 3 or more. Very high…

…closely than HFpEF. Patients are more commonly male and younger than those with HFpEF and have a greater likelihood of coronary artery disease, which is…

…and Survival The presence of LBBB has several implications for patient outcomes: Mortality in STEMI : Patients presenting with ST elevation myocardial infarction (STEMI) and bundle…

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

…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…

…identify cases with ST segment elevations, which demand urgent coronary angiography with the intent to perform PCI. The decision to transfer the patient to the…

…of upper abdominal pain. An ECG recording costs approximately $10 (10€) and may reduce morbidity and mortality substantially in patients with acute coronary syndromes. Importantly…

…Discordant ST T change in a patient not on digoxin treatment 3 Discordant ST T change in a patient on digoxin treatment 1 ECG signs…

…fused with the T wave should be included in the measurement. This may result in an overestimation of the QT interval. If the patient uses…

…bundle branch block in a patient presenting with chest discomfort is strongly suggestive of ongoing ischemia/infarction. Among all patients with acute myocardial infarction the…