…poorer absorption. Injection into an arm with a dialysis fistula. Preparation and equipment Hand disinfection; gloves where there is a risk of blood contact. An…

…both methods falls steeply with the time since ingestion, and both can harm the patient through aspiration. Contact your national or regional poison control centre…

…remains consequential, and historically 2–6% of patients discharged with presumed non ischaemic chest pain were subsequently found to have had an infarction. Pathophysiological Considerations…

…the posterior triangle of the neck, and the superficial nerves of the forearm and the dorsum of the hand. Preparation and equipment Chlorhexidine in alcohol…

…8%. This implies that approximately one third of the patients who ultimately had a favorable neurological recovery exhibited an abnormal pupillary reflex upon initial examination…

…infarction (AMI), in which myocardial ischaemia is accompanied by cardiomyocyte necrosis and cardiac troponin release meeting the criteria of the universal definition of MI. Clinically…

…a dialysis patient, in severe acute kidney injury, in treatment failure or in ongoing massive potassium release. In cardiac arrest with suspected hyperkalaemia, advanced life…

…a fixed dose is given without assessment, when a modified release preparation is started in an opioid naive patient, or when a conversion between drugs…

…around the clock for health care professionals. Contact the centre early in serious, unusual or unclear poisoning, with modified release preparations, mixed poisoning, pregnancy, children…

…injury is separate from MI. It refers to cardiac troponin release that does not fulfil the criteria for ischaemic myocardial infarction. It may be acute…

…recurrent narrowing within a previously implanted coronary stent. It represents a form of arterial hyperplastic disease arising after percutaneous coronary intervention (PCI). In contemporary practice…

…markers of myocardial wall stress. They are released principally by ventricular cardiomyocytes in response to increased transmural stress and ventricular stretch. Atrial natriuretic peptide is…

…which results in thrombus formation (Figure 1). Disruption of an atherosclerotic plaque may also release atherosclerotic debris downstream, causing microvascular embolization (i.e occluding smaller…

…modified release preparation before the daily requirement is known. Duplication. Check that the patient is not already on an opioid patch, a modified release tablet…

…this pattern. Endothelial dysfunction may contribute to both microvascular and epicardial vasomotor disorders. Endothelial activation can promote the release of adhesion molecules, inflammatory cytokines, and…

…injury. Mechanisms of troponin release Troponin I and troponin T are components of the myocardial contractile apparatus and are expressed predominantly in cardiac muscle. Troponin…

…if more than one hour has elapsed post ingestion unless the ingested substance has the propensity to form bezoars or is a sustained release formulation…

…cTnI is the most cardiac specific biomarker. Troponin T (cTnT) is cardiac specific but the cTnT assays also detect proteins released from skeletal muscle. Consequently…

…and parasympathetic influences; sympathetic stimulation leads to vasoconstriction through the release of norepinephrine, while parasympathetic activation can cause vasodilation via acetylcholine release. These mechanisms collectively…

…and Pathophysiological Basis High sensitivity cardiac troponin (hs cTn) assays detect circulating troponin released from injured cardiomyocytes at substantially lower concentrations than earlier generation assays…

…0 μg/kg/min. + ++++ + +++++ Medium dose dopamine activates β1, releases norepinephrine and thus increases contractility, chronotropy and mild increase in SVR. Ventricular arrhythmias Myocardial…

…0 μg/kg/min. + ++++ + +++++ Medium dose dopamine activates β1, releases norepinephrine and thus increases contractility, chronotropy and mild increase in SVR. Ventricular arrhythmias Myocardial…

…10.0 μg/kg/min + ++++ + +++++ Intermediate dose dopamine activates β1, releases noradrenaline and thereby increases contractility and chronotropy, with a slight rise in SVR…

…and atherosclerosis. Ectopic fat deposited around or within the heart and kidneys may exert direct compressive effects and releases additional inflammatory and profibrotic mediators. Perinephric…