…SVT) with wide QRS complex. The algorithm entails 5 criteria, which are tested sequentially (Figure 1). Figure 1. Flowchart of Brugada's algorithm for distinguishing…

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

…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…

…Corticosteroids and other immunosuppressive treatments can blunt the febrile response. A neutropenic patient with a suspected infection and organ dysfunction must therefore be managed as…

…patient. A transfusion set with a filter. Blood components must not be given through a set without a filter. Sodium chloride 9 mg/mL for…

…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…

Procedurer For many patients a gynaecological examination is associated with a sense of exposure, and technically correct performance is only half the task. The examination…

…recognizes vasoreactivity subgroups among patients with idiopathic PAH, including acute responders and non responders. Left heart disease is the most common risk factor for PH…

…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 patient's usual saturation. Previous exacerbations and hospital admissions. Current inhaled treatment and adherence. Opioids, benzodiazepines and other sedating drugs. Thromboembolic risk, for example…

…or peaked pupil suggests perforation. Look for hyphaema — blood with a fluid level in the anterior chamber, best seen with the patient sitting up. 3…

…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…

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

…in patients with preserved LVEF, for whom no practical risk prediction tool currently exists. At the other end, roughly two thirds of ICDs implanted for…

…clean with a tracheostomy or copious secretions Subclavian vein Most comfortable for the patient, the most stable dressing, lowest risk of infection and thrombosis with…

…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…

…any other precipitating factor. Thresholds The thresholds below are used above all in diabetes. The severity of the symptoms and the patient's need for…

…or a smaller measured blood loss if there is physiological compromise. Do not wait for hypotension in young, pregnant or previously athletic patients. Beta blockade…

…L/min — the patient then rebreathes carbon dioxide from the mask Mask with a reservoir 10–15 L/min 60–90 % For acute severe hypoxaemia…

…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…

…EMI. The perioperative strategy should also recognize that CRT patients may rely on continuous biventricular pacing for haemodynamic stability. In patients with resynchronization devices, maintaining…

…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…

…Extracorporeal Life Support for Hypothermic Cardiac Arrest Patients). Please refer to HOPE Score. Severity Features Body temperature (°C) Mild hypothermia Conscious with tremors 32 35°C…

…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…

…Patients with extensive subcutaneous fat require harder pressure. Orientation index marker All ultrasound transducers have an index marker, which is used for orienting in the…

…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 with other bleeding risk assessment tools, notably ATRIA and HAS BLED: HAS BLED Score: In a study evaluating bleeding risk prediction in AF patients…

…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 NSTE ACS undergoing angiography, approximately 10% have no critical epicardial stenosis. In some of these patients, microvascular obstruction or epicardial spasm may account for…

…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…

…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…

…patient quickly into the supine position with the head extended approximately 20–30° below the horizontal, maintaining the 45° rotation. 4. Observe the eyes for…

…actively look for another , in the other nostril, in the ears and in the mouth. Nose 1. Ask the patient to blow the nose gently…

…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…

…Preparation: The patient must have rested lying down for at least 10 minutes in a room at a comfortable temperature — a cold foot gives falsely…

…with chlorhexidine in alcohol 5 mg/mL, sterile drape, sterile gloves, mask and cap. Lidocaine 10 mg/mL for local anaesthesia in the awake patient…

…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…

…determines the diagnosis, and it is asked of a patient who is haemodynamically stable enough for there to be time to ask it. Indications Wide…

…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…

…Heart failure with an LVEF greater than 40%—comprising HFmrEF and HFpEF—accounts for approximately half of patients with symptomatic heart failure. These patients experience…

…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…

…In patients presenting with concurrent sepsis and cardiac arrest, standard cardiopulmonary resuscitation (CPR) protocols are followed. Moreover, for optimal management in the context of sepsis…

…from other fields (e.g. sepsis research) or physiological reasoning. Cardiac arrest care is advanced and should preferably only be conducted in specialized centers. Patients…

…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…

…larger myocardial mass, the QRS duration may be slightly prolonged. For the same reason, R wave peak time may also be prolonged. This prolongation may…

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

…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…