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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…

Injection technique — intramuscular, subcutaneous and intradermal

…which causes the shoulder injury known as SIRVA. Both are avoided with the right landmark and the right needle length. Indications Route Typical drugs Absorption :…

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…

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…

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

…alkali) — it makes endoscopic assessment more difficult and causes vomiting Medicinal charcoal Petroleum products — vomiting with chemical pneumonitis as a consequence Medicinal charcoal Bowel obstruction…

Hyperkalaemia: quick reference for emergency treatment

…Record a 12 lead ECG and start cardiac monitoring at a plasma potassium above 6.0 mmol/L, and at lower values if the rise…

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

…longer episodes, a lower threshold for provocation, or symptoms that awaken the patient from sleep. Initial symptoms of NSTEMI and UA may be similar. NSTEMI…

In-Stent Restenosis: Mechanisms and Treatment

…disease arising after percutaneous coronary intervention (PCI). In contemporary practice, ISR remains the most frequent cause of PCI failure, despite its substantially lower incidence with…

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