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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…

Injection technique — intramuscular, subcutaneous and intradermal

…larger volumes and depot preparations; safer than the dorsogluteal site because the sciatic nerve and the superior gluteal artery are avoided. The patient lies on…

Chest Pain in the Emergency Department: Diagnostic Pathways

…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…

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

…symptoms, the rate of rise, renal function and the clinical context , not by the potassium value alone. A normal ECG does not exclude dangerous hyperkalaemia…

Poisoning: quick reference for antidotes and initial management

…or repeated a modified release preparation or a combination product concurrent drugs, alcohol and illicit substances weight, age, pregnancy and comorbidity renal and hepatic function…

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

…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…

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