…instability. Evaluation and physical examination Initial assessment should establish whether AF is associated with acute haemodynamic compromise, pulmonary oedema, or evidence of coronary ischaemia. These…

…infarction and it is associated with poorer survival. Patients with unstable angina pectoris with low risk (according to TIMI score or similar) may undergo stress…

…cases, enhanced elimination. For many poisonings, well delivered supportive treatment matters more than the antidote [1,2]. Telephone your national or regional poison control centre …

…Haemodynamics Right ventricular strain (echo or CT) Troponin Management : : : : : High Unstable Yes Often raised Reperfusion, intensive care Intermediate–high Stable Yes Raised Admission with monitoring…

…patients with risk factors. Check what applies in your own region. The time limit is not a guarantee. Where the stroke risk is high or…

…inflammation may be faint or absent. Take cultures immediately, but never let sampling, imaging, the blood count or contact with the patient's own clinic…

…at least a few centimetres away from them Full bladder Have the patient void, or catheterise, before puncture Pregnancy, previous extensive abdominal surgery Ultrasound guidance…

…deal in a conscious patient. Indications Immediate (transcutaneous) pacing in bradycardia with haemodynamic compromise — hypotension, shock, impaired consciousness, heart failure, myocardial ischaemia or syncope — that…

…PEF or FEV1 if the patient can manage it without delaying treatment. 10. Call anaesthetics and intensive care early with life threatening features or an…

…treatment. 5. With severe symptoms: give hypertonic saline immediately. Do not wait for a complete work up of the cause or for imaging. 6. Document…