…while for witnessed cardiac arrests, the survival rate stands at 73% (Podsiadlo et al.). A significant majority of these patients exhibit satisfactory neurological function upon…

…for aminoglycosides and when estimating creatinine clearance in obese patients. Lean body weight is used for propofol and rocuronium; actual weight for suxamethonium and for…

…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…

…may be the only signs of infection. Corticosteroids and other immunosuppressive treatments can blunt the febrile response. A neutropenic patient with a suspected infection and…

…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…

…worse when the patient moves the head is therefore not evidence of BPPV. Step 2: decide whether HINTS may be used HINTS stands for Head

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…

…been used in therapeutic studies of pulmonary arterial hypertension (PAH). The threshold is not absolute: patient phenotype, risk factors for heart failure with preserved ejection…

…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…

…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…

…the visual acuity before anything else is done. The second most important is to look for signs of perforation — Seidel's sign, an irregular pupil…

…transmission risk assessment. In DCD: patients in whom death must be confirmed after a 20 minute no touch period, for example after poisoning, since this…

…day of the test can therefore be given dexamethasone. That is the practical key: the patient does not have to be left unprotected for the…

…the majority of sudden cardiac deaths occur in patients with preserved LVEF, for whom no practical risk prediction tool currently exists. At the other end…

…risk of pneumothorax Uncomfortable for an awake patient, harder to keep the dressing clean with a tracheostomy or copious secretions Subclavian vein Most comfortable for…

…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…

…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…

…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…

…Venturi mask with a set of valves, and a high flow nasal cannula where available. Bag mask equipment for a patient who is not breathing…

…stratification The calculator helps identify patients at high risk of SCD who may benefit from preventive interventions, such as ICD implantation. For example: A 5…

…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…

…in higher risk circumstances, particularly for pacing dependent patients, patients with CRT, and ICD recipients undergoing procedures likely to generate EMI. Assess pacing dependence Determining…

…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…

…was the reason for conducting the test). Chest pain rated as 6 or above (according to the 10 point scale) should prompt termination of the…

…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…

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

…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…

…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…

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

…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…

…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…

…that 75% of patients have increased plasma levels of catecholamines. References A recent consensus document has been issued by the European Society for Cardiology: Lyon…

…Observe the eyes for 30–60 seconds. 5. Sit the patient up again and observe the eyes for a further period — reversal of the nystagmus…

…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…

…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…

…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…

…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…

…accounts for approximately half of patients with symptomatic heart failure. These patients experience substantial morbidity and mortality, despite often having a considerable burden of non…

…a risk factor for death [15]. For patients with LBBB and a left ventricular ejection fraction (LVEF) $< 35%$, the implantation of a defibrillator…

…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…

…importance of timely and appropriate interventions. In patients presenting with concurrent sepsis and cardiac arrest, standard cardiopulmonary resuscitation (CPR) protocols are followed. Moreover, for optimal…

…suitable for stable (hemodynamically and respiratory) and fully conscious patients who experienced a brief cardiac arrest. Post resuscitation care is an integral component of the…

…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…