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Injection technique — intramuscular, subcutaneous and intradermal

…injection is placed too high — which causes the shoulder injury known as SIRVA. Both are avoided with the right landmark and the right needle length…

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…

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…

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…

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

…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

…Clinical presentation and symptoms Clinical presentation is heterogeneous. Patients may have: Chest pain, pressure, tightness, heaviness, or discomfort. Pain radiating to the neck, jaw, shoulders…

In-Stent Restenosis: Mechanisms and Treatment

…through intimal thickening. DES release antiproliferative and anti inflammatory agents from the stent surface and have substantially reduced this process compared with BMS. Neoatherosclerosis Neoatherosclerosis…

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