…a unit is selected electronically against the blood group Standard for planned transfusion in a patient without irregular red cell antibodies Serological crossmatch (MG test…

…major haemorrhage protocol early. Protocols improve above all the logistics, the communication and the simultaneous delivery of red cells, plasma and platelets. Observational data from…

Echocardiography Tissue Doppler (Tissue Velocity Imaging) Previous chapters on Doppler imaging have all focused on measurements of blood flow. However, the Doppler effect can also…

…early on does not exclude major bleeding. In acute blood loss, plasma and red cells are lost simultaneously, which means the haemoglobin can be normal…

…entity requiring immediate reperfusion therapy. The pathophysiology of myocardial infarction injury involves the overlapping of vulnerable plaque and thrombogenic blood, which are critical determinants for…

…pool, numerous macrophages or foam cells, and a thin fibrous cap. Disruption of the cap exposes the lipid core and extracellular matrix to circulating blood…

…necessary. After previous punctures: change side, and avoid irradiated fields. Preparation and equipment Informed consent, current full blood count and coagulation screen, medication list. Chlorhexidine…

…thawing, that a blister (sometimes a blood blister) is to be expected, that the area will be red and weeping for a week or so…

…pulse repetition frequency (PRF) is reduced when obtaining both a 2D image and Doppler signals simultaneously. If the blood flow velocity exceeds the Nyquist limit…

…without delay, in any of the following: A systolic blood pressure < 90 mmHg caused by the arrhythmia. Ongoing myocardial ischaemia with chest pain and…

…processed meat and, usually, red meat. The principal evidence supported patterns are Mediterranean type and DASH style diets. Their effects are multidimensional and cannot be…

…or in the wind. Suspected corneal abrasion. A red eye where the diagnosis is not obvious. Suspected acute glaucoma (tonometry). Contraindications Absolute contraindications to instrumental…

…A sterile oesophageal electrode, usually with colour coded connectors (red and black) and a stiffening stylet. A Rostock filter or an equivalent amplifier unit between…

…Index) gives 1 point each for age 80 years, cancer, chronic cardiac or pulmonary disease, a pulse ≥ 110/min, a systolic blood pressure < 100…

Cardiology Genetic and miscellaneous conditions Clinical Red Flags Raising Suspicion of Cardiac Amyloidosis Demographic and Clinical Context Cardiac amyloidosis should be suspected in patients older…

…death: what the new Nature study shows Low risk (blue) versus high risk (red) ECG morphs in lead aVL (adapted from Obermeyer et al 1 )…

…heart failure or recent myocardial infarction. Red flags — investigate further instead Finding Suggests : : Nystagmus that is purely vertical, downbeating or direction changing Central cause Nystagmus…

…be visible in one or a few leads. Figure 1. Stimulation artifact (red arrows) in ventricular pacing. 25 mm/s. In addition to stimulation artifacts…

…propagated and reflected . Red waves represent sound waves that are generated when the vocal cords vibrate. Blue waves represent sound waves reflected by the object…

CPR Each recording presents two leads recorded simultaneously. Sex : Male Age : 43 years History : None Medications : None ECG 1 . Sinus rhythm interrupted by rapid ventricular…

…weight). Red flags and pitfalls Creatinine is a poor measure in the frail and the elderly. A normal creatinine can conceal markedly reduced renal function…

…Doses in atrial fibrillation Drug Standard dose Reduced dose and criterion : : : Apixaban 5 mg twice daily 2.5 mg twice daily if at least two…

…which must be tapered in a controlled fashion). The management is the opposite in each case. Equivalent doses Agent Equivalent glucocorticoid dose Mineralocorticoid effect Biological…

…infection The insulin requirement rises, often despite a reduced food intake Insulin pump The patient manages the pump themselves where possible. In impaired consciousness or…

…respiratory depression. Avoid the combination, or reduce both Red flags and pitfalls A respiratory rate < 8/min, or an increasing level of sedation , are…

…change in flow profile results in the formation of a hemisphere with several layers. Flow velocity is equal within each layer (Figure 1). Figure 1…

…Below are sequential ECG recordings during a sudden cardiac arrest in a 43 year old male. Each ECG presents two leads recorded simultaneously. ECG 1 …