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Injection technique — intramuscular, subcutaneous and intradermal

…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…

Chest Pain in the Emergency Department: Diagnostic Pathways

…injury leads to release of cardiac troponin, but troponin elevation is not specific for myocardial infarction. Other conditions may produce cardiomyocyte injury and elevated troponin…

Opioid therapy in severe pain

…pain and pain in the palliative phase. Severe breathlessness in the palliative phase (at lower doses than for pain). An opioid is rarely the right…

Interpreting NT-proBNP and BNP in Clinical Decision-Making

…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…

Unstable Angina: Definition and Contemporary Management

…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…

Gastric lavage and activated charcoal

…including carbamazepine, theophylline and quinine. Repeated dosing may also be appropriate after large ingestions of modified release preparations. Contraindications Measure Contraindication : : Medicinal charcoal A reduced…

Hyperkalaemia: quick reference for emergency treatment

…1. Perform an ABCDE assessment, attach cardiac monitoring, secure intravenous access and record an ECG. 2. Confirm the potassium with a repeat sample, but do…

Poisoning: quick reference for antidotes and initial management

…with modified release preparations, mixed poisoning, pregnancy, children, a need for an antidote or dialysis, and whenever the clinical course deviates from what was expected…

Acute Coronary Syndrome: Definitions and Initial Triage

…in symptoms or clinical signs, with or without diagnostic electrocardiographic abnormalities and with or without an acute rise in cardiac troponin. The spectrum ranges from…

In-Stent Restenosis: Mechanisms and Treatment

…prevents the external constriction that characterizes restenosis after balloon angioplasty. The biological response therefore occurs primarily through intimal thickening. DES release antiproliferative and anti inflammatory…

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