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Injection technique — intramuscular, subcutaneous and intradermal

…Preparation and equipment Hand disinfection; gloves where there is a risk of blood contact. An alcohol or chlorhexidine swab. Let the skin dry completely before…

Chest Pain in the Emergency Department: Diagnostic Pathways

…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…

Opioid therapy in severe pain

…effect varies tenfold between individuals, and the only way to find the right level is to give a small dose, wait until it has worked…

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

…preparations: in practice within about 1 hour. Tablets and solid preparations: up to about 2 hours. Modified release preparations, anticholinergics, opioids and salicylate — where gastric…

Hyperkalaemia: quick reference for emergency treatment

…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…

Poisoning: quick reference for antidotes and initial management

…skin, smell, injection marks, medication patches and trauma. Remove contaminated clothing and wash the skin after external exposure A low Glasgow Coma Scale is not…

Acute Coronary Syndrome: Definitions and Initial Triage

…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…

In-Stent Restenosis: Mechanisms and Treatment

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

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