…A falling rate, bradypnoea or apnoea Pulse Under 110 per minute At least 110 per minute Bradycardia or arrhythmia PEF Over 50 percent of personal…

…Low body mass index Asian ancestry Previous muscle disease or a personal or family history of muscle disorders Acute infection Renal or hepatic impairment Hypothyroidism…

…showing severe hypercholesterolaemia. A personal history of premature CAD, cerebral vascular disease or peripheral vascular disease. A family history of premature myocardial infarction, vascular disease…

…Procedure Anterior shoulder dislocation The commonest of all dislocations. There is a hollow beneath the acromion, the arm is held in slight abduction and external…

…score Calcium score in each coronary vessel Age , sex , and race based percentile Comparison with the expected score for a person of the same age…

…Lathundar Key message Fever in a neutropenic patient is an emergency. Infection can progress rapidly, while the typical local signs of inflammation may be faint…

…the deceased person's own wishes are properly established. Two things determine the outcome — that the confirmation of death is carried out in a formally…

…is done wrongly: the patient pinches the nasal bone instead of the soft part, and lets go after two minutes. Management is a ladder — compression…

…majority of examinations included in the standard protocol are performed using two dimensional (2D) imaging. Some measurements are still done using M mode echocardiography. A…

…accuracy. The SYNTAX Score remains a cornerstone in the management of complex CAD, providing a structured approach to revascularization strategy. While it has limitations, its…

…in an otherwise healthy person. There are two ways the procedure fails: the incision is too small, so that the cavity closes again within a…

…95 % of a healthy reference population, which means that one healthy value in twenty falls outside them . Order twelve tests in a healthy person and…

…year risk of ≥10% is considered sufficiently high to support BP lowering treatment, whether through lifestyle intervention, pharmacological therapy, or both. A person may also…

…whereas the arrhythmia is unusual among persons younger than 50 years of age. The overall prevalence in a Western population is 1.0% to 1…

…common type of atrial flutter, the re entry loops around the tricuspid valve in a counter clockwise direction. This yields negative flutter waves in II…

…predictor of overall and cardiovascular mortality. The condition is very common among individuals with heart failure. Notably, beta blockers actually increase chronotropic competency in patients…

…Discharge without a plan. Document what has been changed, who is following it up and when. Sources American Diabetes Association, Standards of Care in Diabetes…

…two sizes in an adult: choose the larger , since a mask that is too small leaks and gives a poorer seal. Procedure Insertion of the…

…in 24 hours [5]. A continuing transfusion requirement while definitive control of the bleeding has not yet been achieved. Penetrating torso injury with shock. A…

…due to dysfunction in the sinoatrial node is referred to as sinus node dysfunction (SND). If a person with ECG signs of SND is symptomatic…

…of the foot and toes. Pain that is worse at night or when the limb is horizontal. Improvement when the leg is placed in a…

…quality of life and psychological well being. Physical inactivity is itself a major cardiovascular risk factor. Sedentary behaviour may confer risk even in individuals who…

…for various interventions involved in BLS and ACLS. Intervention BLS or ACLS NNT to save 1 person Reference Early detection of cardiac arrest BLS 11…

…to keep the person alive until resources and skills to provide ACLS arrive. However, rapid administration of BLS in the event of sudden cardiac arrest…

…incidence of treated cardiac arrests outside hospitals (OHCA) is about 70 cases per 100,000 person years in Europe ( EuReCA One, Benjamin et al ). A…

…due to dysfunction in the sinoatrial node is referred to as sinus node dysfunction (SND). If a person with ECG signs of SND is symptomatic…

…Fortunately, most children (even the youngest) can be distracted by a parent or other personnel. Distracting the child during ECG recording may be recommended to…

…will be depolarized in the opposite direction and thus generate a negative (retrograde) P wave (Figure 2). Thus, the P wave morphology of premature atrial…

…the impulse is discharged in the ventricles it will spread partly or entirely outside of the conduction system and thus produce a wide QRS complex…

…Survival in cardiac arrest is highly dependent on the initial rhythm (first recorded rhythm). The initial rhythm is a marker of several crucial events and…

…regular if the person holds the breath. However, sinus arrhythmia may be a pathological finding in some cases. Sinus arrhythmia is not a normal finding…

…hand paresis in a person of working age Blood pressure Measure initially in both arms if this does not delay reperfusion treatment. A large side…

…are used above all in diabetes. The severity of the symptoms and the patient's need for help matter more than a single measured value…

…unresponsive. I B In patients without ST segment elevations, urgent angiography is considered after resuscitation if there is a high probability of ongoing myocardial ischemia…

…The modern concept of rehabilitation has evolved from early post infarction physical activity programmes into a structured centre of secondary cardiovascular prevention in which exercise…

…a refractory right bundle branch and therefore the impulse is conducted with right bundle branch block morphology. This is an example of how changes in…

…reference limit is currently the 99th percentile in a healthy population. Troponin levels higher than the 99th percentile of a normal population are considered elevated …

…RATING LEVEL OF EXERTION COMMENT 6 No exertion at all 7 7.5 Extremely light exertion 8 9 Very light exertion For a healthy person…

…In a fascicular block, the myocardium without fascicular supply will depend on impulses spreading from other parts of the ventricle (where the fascicle is intact…

…Although the risk of cardiac arrest is very small, personnel must be well trained in resuscitation. Subject preparations The procedure must be explained carefully to…

…not caused by the passive deposition of lipids into the coronary artery walls; indeed, atherosclerosis is a disease in which the immune system elicits an…

…are balanced and no ischemia occurs. (Some individuals display a benign form of ischemia located in the subendocardium during exercise; this manifests with ST segment…

…dysfunction is also associated with a high risk of developing supraventricular tachyarrhythmias, especially atrial fibrillation and atrial flutter. The condition in which sinus node dysfunction…

…abstract)): Sensitivity : EMS personnel demonstrate high sensitivity in detecting STEMI, with one study reporting a sensitivity of 75%. Thus, 25% of STEMI cases are missed…

…intervention has an NNT of 10, then 10 people must be treated to save 1. Thus, the greatest opportunities exist in the first few minutes…

…an unexpected death due to cardiac causes that occur within 1 hour of symptom onset. The person may or may not have known cardiac disease…