…arrests, the survival rate stands at 73% (Podsiadlo et al.). A significant majority of these patients exhibit satisfactory neurological function upon discharge. Figure 1 . Expected…

…4 × (actual weight − ideal weight). Used for aminoglycosides and when estimating creatinine clearance in obese patients. Lean body weight is used for propofol and rocuronium…

…is an uncommon cause of ventricular tachycardia, it is important to be able to differentiate these entities. The older the patient and the more significant…

…For patients with bundle branch blocks, the corresponding figure is 500 ms. The QT interval represents the time between the onset of ventricular depolarization and…

…compression. The reason compression nevertheless so often fails is that it is done wrongly: the patient pinches the nasal bone instead of the soft part…

…neutropenic fever is limited, but delayed antibiotics are associated with a worse outcome in sepsis and in several studies of neutropenic patients. In septic shock…

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

…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…

…precapillary PH, partly because this value has been used in therapeutic studies of pulmonary arterial hypertension (PAH). The threshold is not absolute: patient phenotype, risk…

…likelihood of atherosclerotic obstructive CAD. CAC is therefore not merely an incidental imaging finding; it can refine the decision to test and may identify patients…

…of hypercapnia and a normal blood gas Usually 94 to 98 percent An individually documented target prescription, for example in chronic hypercapnia Follow the patient…

…against the band and the chin in the rest. Support your working hand against the patient's zygoma or the bridge of the nose. 4…

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

…often the very question at issue A patient who needs steroid cover simply to get through the day of the test can therefore be given…

…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…

…compressible if bleeding occurs, low risk of pneumothorax Uncomfortable for an awake patient, harder to keep the dressing clean with a tracheostomy or copious secretions…

…test before stopping During and after the taper the patient must be informed about the stress dosing rules and about the symptoms of adrenal insufficiency…

…the sample and send a venous plasma glucose, but do not delay treatment of a neurologically compromised patient. Continuous glucose monitoring reflects interstitial glucose and…

…value of around 0.9 to 1.0 or higher in an adult trauma patient suggests significant hypovolaemia and an increased transfusion requirement. Pregnancy, medication…

…why, or the patient at risk of carbon dioxide retention is given 15 litres on a reservoir mask and drifts off into a respiratory acidosis…

…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…

…In stable patients, it is advisable to add therapy with beta blocking agents before full target doses of ACE inhibitors are reached. Medication doses should…

…be individualized according to the patient, device, procedure, and anticipated electrical environment. Preoperative evaluation Establish the nature and function of the device The following should…

…Chinese and Malay patients, may have higher statin blood levels; lower starting doses are therefore appropriate. Drug interactions are particularly important. Inhibition of cytochrome P…

…Some patients have frequent symptomatic episodes, whereas others have brief or asymptomatic episodes that are not detected during routine clinical assessment. The clinical burden of…

…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…

…tailored to the patient's needs. Programming is done through an external device that communicates wirelessly with the pacemaker. A wide range of settings can…

…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…

…RWT (Relative Weight Thickness), provided that the patient's weight, height and sex are entered. RWT is a measure of the type of hypertrophy. Generally…

…the ribs increase, providing larger windows for the ultrasound beam. The operator can sit on either side of the patient, depending on preferences. The operator…

…rotation, and the patient resists internal rotation. Check the axillary nerve: sensation over the lateral part of the deltoid before and after the reduction , together…

…Lip GY. Performance of the HEMORR₂HAGES, ATRIA, and HAS BLED bleeding risk prediction scores in patients with atrial fibrillation undergoing anticoagulation: the AMADEUS study. J…

…may influence treatment selection and tolerability. Whether the patient has persistent or progressive disease suggestive of an advanced phenotype. Particular attention should be paid to…

…left ventricular hypertrophy. Among patients with NSTE ACS undergoing angiography, approximately 10% have no critical epicardial stenosis. In some of these patients, microvascular obstruction or…

…branch block. Paper speed 50 mm/s. Type 1 Brugada syndrome reminds somewhat of right bundle branch block (RBBB) in leads V1–V3, but the…

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

…function and catecholamine toxicity. The latter theory is corroborated by the finding that 75% of patients have increased plasma levels of catecholamines. References A recent…

…patient or by an inexperienced examiner it is unreliable. A single central feature is enough to proceed with urgent investigation , and a normal CT of…

…live insect As soon as possible — kill it first; the patient is in great distress Organic material (peas, beans) The same day — it swells when…

…department [1,3]. Step 1: confirm the blood pressure and stabilise the patient Immediate assessment 1. Assess airway, breathing, circulation and level of consciousness. 2…

…prevents the patient from tolerating compression. Preparation and equipment Equipment: a handheld Doppler probe 5–10 MHz, ultrasound gel, a blood pressure cuff of the…

…cap. Lidocaine 10 mg/mL for local anaesthesia in the awake patient — the anaesthetic also improves the chance of success by counteracting vascular spasm. Pressure…

…fluid responsiveness poorly. Dynamic measures are better: a pulse pressure variation 13% in a ventilated patient in sinus rhythm without spontaneous breathing, passive leg raising…

…lower leg in a patient with peripheral arterial disease or diabetes — the wound may not heal. Over superficial nerves (the lateral aspects of the fingers…

…over the volar nerve. Wait 10 minutes — insufficient waiting time is the commonest reason for the patient finding the procedure painful. Test with a needle…

…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…

…and intubation can precipitate circulatory collapse in a tamponaded patient , since positive airway pressure further reduces the venous return. Procedure Choice of access The ultrasound…

…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…

…50%. A patient with persistently mildly reduced systolic function. This dynamic nature makes prior imaging particularly important when interpreting a current LVEF of 41–49%…

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

…Patients with hypotension, marked low output, or persistent severe symptoms require close monitoring and consideration of invasive haemodynamic assessment when precise measurements are needed to…

…a result of asphyxia or hypoxia is managed according to the standard CPR algorithm, except that interventions to reoxygenate the patient is of paramount importance…

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

…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…

…hours ( Soar et al ). The causes of death among these patients are complications related to PACS: 60% die from neurological injuries. 30% die from hemodynamic…

…10€) and may reduce morbidity and mortality substantially in patients with acute coronary syndromes. Importantly, the ECG findings dictate the management of acute coronary syndromes…

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

…For patients with bundle branch blocks, the corresponding figure is 500 ms. It is recommended that the automatic (machine) calculation of the corrected QT interval…