…the right needle length. Indications Route Typical drugs Absorption : : : Intramuscular (IM) Vaccines, depot antipsychotics, hydroxocobalamin, adrenaline in anaphylaxis, ceftriaxone, ferric carboxymaltose Rapid, 10–20 min…

…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…

…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…

…is myocardial ischaemia caused by an acute coronary process. Myocardial injury leads to release of cardiac troponin, but troponin elevation is not specific for myocardial…

…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…

…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…

…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…

…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…

…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…

…repeated after 5–10 min as needed Halve the dose in older people and in renal failure Morphine PO 5–10 mg as needed The…

…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…

…Bradycardia (second line alternative) Medium dose : 3.0 10.0 μg/kg/min. + ++++ + +++++ Medium dose dopamine activates β1, releases norepinephrine and thus increases contractility…

…Bradycardia (second line alternative) Medium dose : 3.0 10.0 μg/kg/min. + ++++ + +++++ Medium dose dopamine activates β1, releases norepinephrine and thus increases contractility…

…line option). 3.0–10.0 μg/kg/min + ++++ + +++++ Intermediate dose dopamine activates β1, releases noradrenaline and thereby increases contractility and chronotropy, with a…

…jawline, the ears. Anatomically hazardous areas: the branches of the facial nerve at the temple, the accessory nerve in the posterior triangle of the neck…

…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…

…pupillary reflex. Importantly, pupillary size and reactivity are influenced by factors beyond neural activity. Systemic catecholamines released or administered during resuscitation can affect pupil to